دورية أكاديمية

High risk medicolegal autopsies: is a full postmortem examination necessary?

التفاصيل البيبلوغرافية
العنوان: High risk medicolegal autopsies: is a full postmortem examination necessary?
المؤلفون: Fryer, Eve Patricia, Traill, Zoe C, Benamore, Rachel E, Roberts, Ian S D
بيانات النشر: British Medical Journal Publishing Group
سنة النشر: 2013
المجموعة: HighWire Press (Stanford University)
مصطلحات موضوعية: Original articles
الوصف: Aims Aiming to reduce the numbers of high risk autopsies, we use a minimally invasive approach. HIV/hepatitis C virus (HCV)-positive coronial referrals, mainly intravenous drug abusers, have full autopsy only if external examination, toxicology and/or postmortem CT scan do not provide the cause of death. In this study, we review and validate this protocol. Methods and results 62 HIV/HCV-positive subjects were investigated. All had external examination, 59 toxicology and 24 CT. In 42/62, this minimally invasive approach provided a cause of death. Invasive autopsy was required in 20/62, CT/toxicology being inconclusive, giving a potential rather than definite cause of death. Autopsy findings provided the cause of death in 6/20; in the remainder, a negative autopsy allowed more weight to be given to toxicological results previously regarded as inconclusive. In order to validate selection of cases for invasive autopsy using history, external examination and toxicology, a separate group of 57 non-infectious full autopsies were analysed. These were consecutive cases in which there was a history that suggested drug abuse. A review pathologist, provided only with clinical summary, external findings and toxicology, formulated a cause of death. This formulation was compared with the original cause of death, based on full autopsy. The review pathologist correctly identified a drug-related death or requirement for full autopsy in 56/57 cases. In one case, diagnosed as cocaine toxicity by the review pathologist, autopsy additionally revealed subarachnoid haemorrhage and Berry aneurysm. Conclusions These findings support the use of minimally invasive techniques in high risk autopsies, which result in a two-thirds reduction in full postmortems.
نوع الوثيقة: text
وصف الملف: text/html
اللغة: English
العلاقة: http://jcp.bmj.com/cgi/content/short/66/1/1Test; http://dx.doi.org/10.1136/jclinpath-2012-201137Test
DOI: 10.1136/jclinpath-2012-201137
الإتاحة: https://doi.org/10.1136/jclinpath-2012-201137Test
http://jcp.bmj.com/cgi/content/short/66/1/1Test
حقوق: Copyright (C) 2013, BMJ Publishing Group
رقم الانضمام: edsbas.64ACB974
قاعدة البيانات: BASE