Incidence of Autopsy Findings in Unexpected Deaths of Children and Adolescents

SAGE Publications - Tập 6 Số 2 - Trang 142-155 - 2003
David M. Parham1,2, Van H. Savell1,2, Charles P. Kokes1,2,3, Stephen A. Erickson1,3, Frank J. Peretti1,3, James B. Gibson2,4, William Q. Sturner1,2,3
1Department of Pathology, University of Arkansas for Medical Sciences, 4301 West Markham, Little Rock, AR 72205, USA
2Department of Pediatric Pathology, Slot 820, Arkansas Children's Hospital, 800 Marshall Street, Little Rock, AR 72202, USA
3Office of the Medical Examiner, Arkansas State Crime Laboratory, 3 Natural Resources Drive, Little Rock, AR 72215, USA
4Department of Pediatrics, University of Arkansas for Medical Sciences, 4301 West Markham, Little Rock, AR 72205, USA

Tóm tắt

Studies in various settings reveal that a significant percentage of autopsies demonstrate findings that were not previously clinically diagnosed. In the pediatric and adolescent age group, forensic examinations comprise a large percentage of total autopsies performed. We hypothesized that a similar number of previously undiagnosed findings would be present in this population and thus reviewed a series of autopsy reports from the Medical Examiners Office in the Arkansas Crime Laboratory. During 1997 through 1999, we performed 439 complete forensic autopsies on children and adolescents (age range 1 day to 19 years; median 18 months). Previously undiagnosed lesions were found in 173 (39%). Of these subjects, 68 (39%) had clinically significant pathology, 60 (35%) had insignificant pathology, and 45 (26%) had pathology of undetermined significance. Thirty-six subjects had lesions expected from a previously diagnosed condition. Of the total number of lesions found, 168 were inflammatory, 58 were congenital anomalies (48 unexpected), and 88 comprised miscellaneous other conditions. Infants < 6 months of age were significantly more likely to have a previously undiagnosed lesion than children > 6 months ( P < 0.0001). Previously undiagnosed findings, mostly inflammatory, occur relatively frequently in pediatric and adolescent forensic autopsies and are more likely to occur in infants.

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