tailieunhanh - Báo cáo y học: "Clinical diagnosis versus autopsy findings in polytrauma fatalities"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: Clinical diagnosis versus autopsy findings in polytrauma fatalities | Buschmann et al. Scandinavian Journal of Trauma Resuscitation and Emergency Medicine 2010 18 55 http content 18 1 55 SCANDINAVIAN JOURNAL OF emergency medicine ORIGINAL RESEARCH Open Access Clinical diagnosis versus autopsy findings in polytrauma fatalities 1 2 1 2 2 3 Claas T Buschmann Patrick Gahr Michael Tsokos Wolfgang Ertel Johannes K Fakler Abstract Objectives The aim of the study was to determine if differences in clinical diagnosis versus autopsy findings concerning the cause of death in polytrauma fatalities would be detected in 19 cases of fatal polytrauma from a Level 1 trauma centre. Methods Clinical diagnoses determining the cause of death in 19 cases of fatal polytrauma 2007 - 2008 from a Level 1 trauma centre were correlated with autopsy findings. Results In 13 cases 68 the clinical cause of death and the cause of death as determined by autopsy were congruent. Marginal differences occurred in three 16 patients while obvious differences in interpreting the cause of death were found in another three 16 cases. Five fatalities three with obvious differences and two with marginal differences were remarked as early death 1-4 h after trauma and one fatality with marginal differences as late death 1 week after trauma . Obvious and marginal discrepancies mostly occurred in the early phase of treatment especially when severely injured patients were admitted to the emergency room undergoing continued cardiopulmonary resuscitation i. e. limiting diagnostic procedures and thus the clinical cause of death was essentially determined by basic emergency diagnostics. Conclusions Autopsy as golden standard to define the cause of death in fatal polytrauma varies from the clinical point of view depending on the patient s pre-existing condition mechanism of polytrauma necessity of traumatic cardiopulmonary resuscitation survival time and thus the possibility to perform emergency diagnostics. An autopsy should be performed at least in cases of early fatal .