Auditing Autopsies: Lagos University Teaching Hospital Experience

A thirteen-month prospective study was carried out to compare clinical (antemortem diagnosis) with autopsies (post-mortem diagnosis) on patients managed at Lagos University Teaching Hospital (LUTH) between October 1999 and November, 2000. In the study period, a total of 1843 deaths were registered out of which 467 autopsy request were made (hospital and coroner's autopsies). Hospital autopsy request were 411 (88%) while coroner's request constituted 56 (12%) of the autopsies. Only 305 (65%) of the autopsies performed are excluded in the study because of inconclusive clinical report and diagnosis or autopsy not done on them. The result showed that the concordance rate between clinical and autopsy diagnosis was found to be 82.1%: and that 71.9% of deaths occurred within 48 hours of presentation and majority of this category of deaths are the least investigated. Forty five percent (45%) of all the group studied had no clinical investigation done. The low autopsy rate and the attitude of medical practitioners to autopsy do not encourage good medical practice and continue medical education. We need to rely more on autopsy audit to study disease processes and to enhance our diagnostic skill. Autopsy audit should be officially adopted as a means of quality control in hospitals. Nig. Medical Practitioner Vol. 44(5/6) 2003: 96-9