Obducties voor huisartsen en voor klinisch werkende specialisten; de indicaties onderzocht

To evaluate the reasons for autopsies requested by general practitioners, compared with autopsies requested by clinicians.

Design

Retrospective descriptive comparative study.

Setting

Department of Pathology, Free University Hospital, Amsterdam; Medical Centre Alkmaar; Regional Laboratory Twente, Enschede and Regional Pathology Laboratory, Blaricum.

Material and method

In a series of 303 autopsies requested by general practitioners, the reasons for the autopsy were divided into the following categories: sudden unexpected death, short fatal course of disease, intrauterine and perinatal death, evaluation of a protracted course of disease, non-natural death, and others. Results were compared with two series of 2961 and 1747 autopsies performed for clinicians in a university hospital and a non-university hospital, respectively.

Results

General practitioners requested autopsy mainly in cases of sudden unexpected death (48,2) and short fatal courses of disease (16,5). For the autopsies requested by clinicians in the university hospital these figures were 6.1 and 15.5, respectively, in the non-university hospital 9.1 and 18.2. Owing to the autopsies requested the percentage of cases with unknown or uncertain cause of death was reduced from 67.1 to 14.4.

Conclusions

General practitioners mainly request autopsy when important questions of themselves or of the bereaved need to be answered. Thresholds for autopsy, including financial ones, need to be eliminated to enable general practitioners to request autopsies.