Contribution of pediatric autopsies to clinical care: Utilization among physicians in a Nigerian tertiary hospital in the past decade

Abstract

Objective: The usefulness of autopsy includes the determination of the cause of death and risk factors of a disease, ascertaining the chances of recurrence and the consequences for relatives, genetic counseling, and planning for future cases and for research. Its utilization has, however, been on the decline in most parts of the world. The researchers set out to determine how much autopsies of pediatric patients are being utilized in a tertiary health facility in Enugu, Nigeria, and the degree of correlation between the clinical and pathologic diagnosis. Design: This was a descriptive cross-sectional study of case notes of pediatric deaths and all pediatric autopsies in the preceding 10 years, noting clinical diagnosis and requests for autopsies and its outcome, and comparing it with pathological diagnosis. Settings: The study was conducted in the departments of pediatrics and histopathology of the University of Nigeria, Ituku-Ozalla campus. Results: There were 1962 deaths with 12 autopsies performed within the period of study. Evidence of request for a postmortem was documented in only four case notes whereas reasons for decline or otherwise were also not noted. There was a 100% correlation of pathological and clinical diagnosis from the available case notes. Conclusions: Autopsies of pediatric patients are almost nonexistent in a university teaching hospital, resulting to poor utilization by physicians. A follow-up study is required to ascertain and manage the cause of the apathy displayed by the attending physicians to the usefulness of autopsies in patient care.

Keywords

• nigeria
• pathologic diagnosis
• pediatric autopsy
• utilization