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  • Introduction of postmortem CT increases the postmortem examination rate without negatively impacting the rate of traditional autopsy in daily practice: an implementation study

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Original research
Introduction of postmortem CT increases the postmortem examination rate without negatively impacting the rate of traditional autopsy in daily practice: an implementation study
  1. Max G Mentink1,
  2. Frans C H Bakers1,
  3. Casper Mihl1,2,
  4. Max J Lahaye3,
  5. Roger J M W Rennenberg4,
  6. Bart G H Latten5,6,
  7. Bela Kubat5,6,
  8. Paul A M Hofman1
  1. 1 Department of Radiology and Nuclear Medicine, Maastricht Universitair Medisch Centrum+, Maastricht, The Netherlands
  2. 2 Department of Radiology, CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, The Netherlands
  3. 3 Department of Radiology, Antoni van Leeuwenhoek, Netherlands Cancer Institute, Amsterdam, The Netherlands
  4. 4 Department of Internal Medicine, Maastricht Universitair Medisch Centrum+, Maastricht, The Netherlands
  5. 5 Department of Pathology, Maastricht Universitair Medisch Centrum+, Maastricht, The Netherlands
  6. 6 Department of Pathology, Netherlands Forensic Institute, Den Haag, The Netherlands
  1. Correspondence to Max G Mentink, Radiology & Nuclear Medicine, Maastricht Universitair Medisch Centrum+, Maastricht 6229 HX, The Netherlands; maxmentink92{at}gmail.com

Abstract

Aim The aim of this implementation study was to assess the effect of postmortem CT (PMCT) and postmortem sampling (PMS) on (traditional) autopsy and postmortem examination rates. Additionally, the feasibility of PMCT and PMS in daily practice was assessed.

Methods For a period of 23 months, PMCT and PMS were used as additional modalities to the autopsy at the Department of Internal Medicine. The next of kin provided consent for 123 postmortem examinations. Autopsy rates were derived from the Dutch Pathology Registry, and postmortem examination rates were calculated for the period before, during and after the study period, and the exclusion rate, table time, time interval to informing the referring clinicians with results and the time interval to the Multidisciplinary Mortality Review Board (MMRB) meeting were objectified to assess the feasibility.

Results The postmortem examination rate increased (from 18.8% to 32.5%, p<0.001) without a decline in the autopsy rate. The autopsy rate did not change substantially after implementation (0.2% decrease). The exclusion rate was 2%, the table time was 23 min, and a median time interval of 4.1 hours between PMCT and discussing its results with the referring clinicians was observed. Additionally, more than 80% of the MMRB meetings were held within 8 weeks after the death of the patient.

Conclusions Our study shows that the implementation of a multidisciplinary postmortem examination is feasible in daily practice and does not adversely affect the autopsy rate, while increasing the postmortem examination rate.

  • anatomy
  • death
  • autopsy
  • image-guided biopsy
  • image processing, computer-assisted

https://doi.org/10.1136/jclinpath-2020-206734

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    Footnotes

    • Handling editor Runjan Chetty.

    • Contributors FCHB, CM, RJMWR, BGHL and PAMH carried out the implementation. All authors were consulted for conceptualising of the study design. MJL and MGM were responsible for the data acquisition. MGM performed the data analysis and was responsible for writing the manuscript. All authors were involved in the final approval of the submitted version.

    • Funding The institutional board provided funding for this prospective study. Funding played no role in the design, conduct or reporting, but did determine the sample size.

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement The data that support the findings of this study are available from the corresponding author MGM, upon reasonable request.