Retrospective study of 20 years of post-mortem examination of young adults

OBJECTIVE: This study is designed to gain insight into the cause of death in deceased young adults, by analyzing autopsies and other post-mortem examinations including their contribution into finding the cause of death DESIGN: Retrospective cohort study. METHOD: Included were adults aged between 18-45 years old who underwent a clinical autopsy at the Isala Klinieken in Zwolle between January 2000 and October 2022. Included patients had a natural cause of deaths and were divided into two categories: expected and unexpected deaths. For each patient the post-mortem examination and their contribution to diagnose the cause of death were determined, among other things. Collected data was processed in a database and analyzed. RESULTS: Between January 2000 and October 2022, 212 autopsies were performed in the 18-45 age group. Of these 212 patients, 54 (25,5%) were expected deaths and 158 (74,5%) unexpected deaths. 116 patients had an unknown cause of death (7 expected vs. 109 unexpected). After post-mortem examination, this number has decreased to 15 deaths (expected 0 vs. unexpected 15). This is a reduction form 54,7% to 7,1%. Of the 96 presumed diagnoses/causes of death for autopsy, 16 (16,7%) cases were reclassified as Goldman score 1 discrepancies. CONCLUSION: Performing post-mortem examinations contributes to reducing the number of unknown causes of death. Post-mortem examinations also provide knowledge about illnesses, the clinical course of syndromes and the actual cause of death in (young) adults, even when mortality is expected