L'autopsia oggi: Una pratica superata o uno strumento per migliorare la qualità delle prestazioni sanitarie?

Introduction Autopsies are a fundamental moment of clinical audit that have been progressively decaying. Materials and Methods The autoptic rates of 6 hospitals of Piedmont Region (1639 autopsies, years 1995-97) were calculated. The Positive Predictive Value and Sensitivity (indicators of concordance between clinical and autoptic diagnosis) were calculated for each diagnosis; all discrepancies were classified as type I (adverse impact on patient's survival) and type II (uncertain impact) clinical errors. The diagnostic performance of medical, surgical and emergency staffs were compared with one another. Results Autopsies are rarely performed on the patients who died in hospital (7,13%). Independently from the diagnosis, the global concordance expresses a Positive Predictive Value of 37,22% and a Sensitivity of 47,71%. 401 type I errors and 307 type II errors were found. The best performance is reached by emergency staff. Aim To evaluate the use and the meaning of autopsies in today's Italian healthcare organisations.