The Value of Post Mortems in Cardiac Surgery: Learning from the Dead

Oxford Heart Centre, John Radcliffe Hospital, Oxford, United Kingdom.
Heart, Lung and Circulation (Impact Factor: 1.44). 12/2011; 21(3):150-3. DOI: 10.1016/j.hlc.2011.11.005
Source: PubMed


Little information is available regarding the role of post-mortem in cardiac surgery. The cause of death by clinical presumption can be misleading. The aim is evaluate the role of post-mortem following cardiac surgery by comparing clinically attributed causes of death versus post-mortem findings.
A total of 10,099 cardiac operations were performed over a seven-year period in a single institution in the United Kingdom. There were 363 (3.6%) deaths. The mean age at death was 71 with 66.7% male. Of these, 348 (95.9%) patients underwent a post-mortem examination.
There was a significant disparity between presumed and actual causes of death in 78 (22.4%) patients. The commonest unrecognised cause of death was cardiac causes (21 patients, 6.0%). The most overestimated cause of death was multi-organ failure, which was incorrectly diagnosed as the cause of death in 28 patients (8.0%).
Post-mortem can determine unsuspected diagnoses in a significant proportion of patients undergoing cardiac surgery. It plays an important role in cardiac surgery and remains essential for quality assessment in perioperative treatment.

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