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Persona de Mediana Edad , Masculino , Humanos , Electrocardiografía , Coma , HipotermiaRESUMEN
OBJECTIVE: A total of 61 autopsies performed in patients died in emergency department of a university hospital were retrospectively analysed and the findings were compared with clinical diagnoses. METHODS: Sensitivity and specificity of the clinical diagnoses and the correction of medical procedures were measured. The influence of age and sex of patients was analyzed using Fisher's exact test and chi-square-test. RESULTS: The most common causes of death were cardiovascular diseases (52.46%). Autopsy showed unexpected major findings in 44.26% of cases. Major discrepancies between the autopsy reports and the clinical diagnoses, were present in 26.22% of all cases. Absolute concordance between clinical and autopsy diagnoses was obtained in 44.26% of cases. The major sensitivity of clinical diagnosis was found in cerebrovascular disorders (100%), upper digestive hemorrhage (100%), and acute myocardial infarction (82.35%). The lowest sensitivity was found in malignant tumors (16.66%), hemorrhagic pancreatitis (0%) and bowel infarction (0%). The patient cares were correct in 68.85% of cases. No statistically significant differences were observed in relation to age and sex. CONCLUSIONS: We concluded that autopsy is a useful method for evaluate diagnostic procedures and quality of medical cares in emergency departments.
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Autopsia , Servicio de Urgencia en Hospital/normas , Errores Médicos , Calidad de la Atención de Salud , Adulto , Anciano , Femenino , Hospitales Universitarios , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , EspañaRESUMEN
Two cases of spontaneous pneumothorax after repeated inhalation of cocaine and forced aspiration of marijuana smoke, respectively, are presented. The absence of pneumomediastinum and associated subcutaneous emphysema in both cases is stressed. Inspiratory manipulations against resistance are assessed as potential etiological factors, although the coexistence of other pneumothorax predisposing factors seems to be necessary.