Please use this identifier to cite or link to this item: https://doi.org/10.1016/S1072-7515(02)01123-7
Title: Unexpected findings in trauma patients dying in the Intensive Care Unit: Results of 153 consecutive autopsies
Authors: Ong, A.W. 
Cohn, S.M.
Cohn, K.A.
Jaramillo, D.H.
Parbhu, R.
McKenney, M.G.
Barquist, E.S.
Bell, M.D.
Issue Date: 2002
Source: Ong, A.W., Cohn, S.M., Cohn, K.A., Jaramillo, D.H., Parbhu, R., McKenney, M.G., Barquist, E.S., Bell, M.D. (2002). Unexpected findings in trauma patients dying in the Intensive Care Unit: Results of 153 consecutive autopsies. Journal of the American College of Surgeons 194 (4) : 401-406. ScholarBank@NUS Repository. https://doi.org/10.1016/S1072-7515(02)01123-7
Abstract: BACKGROUND: The true incidence of missed injuries in trauma-related deaths is unknown, because in only about 60% of injury-related deaths nationwide is an autopsy performed. Few studies have documented the frequency of missed diagnoses leading to deaths specifically in the trauma ICU population. We attempted to evaluate the incidence and nature of missed injuries and complications in trauma- and burn-related deaths in our ICU given an autopsy rate of close to 100% STUDY DESIGN: The medical records of all trauma- and burn-related deaths in the ICU over a 2-year period were reviewed retrospectively. Missed diagnoses were classified as class I: major diagnosis that if recognized and treated appropriately might have changed outcomes; class II: major diagnosis that if recognized and treated appropriately would not have changed outcomes; and class III: minor diagnosis. RESULTS: Complete antemortem records were available for 158 patients, of which 153 (97%) underwent autopsy. Mean age was 50 years, and 72% were males. Mean ICU stay was 10 ± 15 days. Four (3%) patients had class I missed diagnoses: bowel infarction, meningitis, retroperitoneal abscess, and bleeding gastric ulcer. Twenty-five (16%) patients had class II diagnoses, and 12 (8%) patients had class III diagnoses. Overall, 81% of 153 patients had either class III diagnoses or no missed injuries or complications. Pneumonia was the most common missed diagnosis. CONCLUSIONS: With an autopsy rate of 97%, 3% of deaths had missed major diagnoses that might have affected outcomes if recognized antemortem. Autopsy findings can still provide valuable feedback in improving the quality of care of critically ill trauma patients. © 2002 by the American College of Surgeons.
Source Title: Journal of the American College of Surgeons
URI: http://scholarbank.nus.edu.sg/handle/10635/130406
ISSN: 10727515
DOI: 10.1016/S1072-7515(02)01123-7
Appears in Collections:Staff Publications

Show full item record
Files in This Item:
There are no files associated with this item.

SCOPUSTM   
Citations

47
checked on Jan 16, 2018

WEB OF SCIENCETM
Citations

43
checked on Nov 21, 2017

Page view(s)

4
checked on Jan 14, 2018

Google ScholarTM

Check

Altmetric


Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.