Analyzing Annals: Virtual Autopsy With Multiphase Postmortem Computed Tomographic Angiography Versus Traditional Medical Autopsy to Investigate Unexpected Deaths of Hospitalized Patients. A Cohort Study
"Virtual" autopsy by postmortem computed tomography can replace medical autopsy to a certain extent but has limitations for cardiovascular diseases. This study found that the addition of angiography to postmortem computed tomography resulted in the ability to detect cardiovascular diagnoses similar to that of traditional medical autopsy.
Read this article and use the study to consider:
- What is the value of an autopsy? What might we learn about the care we did or did not provide? How might the results of autopsies help quality-improvement efforts at your hospital?
- Look at the videos that accompany this paper (click on the supplemental video links) to see how the computer-generated reconstruction helped identify pathology. Look at the frontal CXR at the end of Supplemental Video 3 and ask if your learners could have identified the misplaced central venous catheter.
- Why has the number of autopsies has decreased? Have doctors lost interest, thinking there is little to be learned? Do they fear litigation based on the findings? Do families think they will need to pay for them? Do autopsies interfere with funeral plans or an open-casket service?
- Consider what it would be like to ask a family whether they would like an autopsy performed. How should the benefits of an autopsy be explained? What questions do families ask?
- Ask to review the autopsy results of a patient who died (gross dissection and histology) with a pathologist. Commit to doing this for all of your patients who have an autopsy. Do you think it is worthwhile, or perhaps even your responsibility?