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Jornal Brasileiro de Patologia e Medicina Laboratorial
On-line version ISSN 1678-4774
ECHENIQUE, Leandro Santini; MELLO, Regina de Arruda; ODASHIRO, Luciana Nakao and FRANCO, Marcello. Relationship between gross and microscopic findings in 200 consecutive autopsies: cost/benefit value of the histopathological study of all organs and systems. J. Bras. Patol. Med. Lab. [online]. 2002, vol.38, n.3, pp. 219-224. ISSN 1678-4774. http://dx.doi.org/10.1590/S1676-24442002000300010.
Background: Despite the development in diagnostic medicine, discrepancy between clinical diagnoses and the ones obtained by autopsy has remained around 10-20%. It is important to revert this tendency by measures that value the realization and optimization of autopsies. Objectives: Prospectively compare gross and microscopic findings of 200 autopsies, viewing to analyze the impact and the cost/benefit value of the histopathological study of all organs over provisory microscopic diagnoses and over enclosure final awards. Methods: We analyzed 200 consecutive autopsies performed at Departamento de Patologia da Escola Paulista de Medicina/Unifesp and evaluated agreement and disagreement between provisory gross diagnoses and final microscopic ones. Results: There was agreement between gross and microscopic findings in 143 cases (71.5%) and disagreement in 22 cases (11%), classified as light in 14 cases (7%) and serious in eight cases (4%). In 35 cases (17.5%), histopathological study revealed alterations with no gross significance which had final histological diagnosis. Conclusion: The high agreement index detected between gross and microscopic findings, most discrepancies being classified as light, seems to indicate that autopsies may be closed with histopathological study limited to the most evident gross alterations, with significant cost reduction (around R$ 300 per autopsy) and great improvement in the return, in a short period of time, of information to the institution clinical staff.
Keywords : Autopsy ; Histopathology ; Cost.