Abstract

BACKGROUND: The aim of the study was to compare autopsy findings with antemortemfindings in children who died in a pediatric intensive care unit. MATERIAL/METHODS: Consecutive seriesof patients who died in the pediatric intensive care unit during 2-year period were used. The study wasconducted as a retrospective chart review at community, regional-referral, university-affiliated tertiarymedical center of 1200 bed in Israel. RESULTS: Permission was given to perform autopsies on only 10 children(23.8%, mean age 85.7 months) out of the 42 who died during the study period. The mean length of stayin the pediatric intensive care unit prior to death was 13.3 days. Cardiac or hemato-oncologic diseasescomprised the major pre-admission diagnoses. The autopsy revealed a major finding that, if known beforedeath, would have altered clinical management in 50% of the patients: pneumonia, pneumonitis as wellas intestinal perforation or necrosis. No correlation was found between patient length of stay in theintensive care unit and the autopsy disclosed information. CONCLUSIONS: Our findings support the importanceof autopsy assessment in the pediatric intensive care setup. We believe that postmortem examination isalso essential for improving the quality of pediatric patient care.

Keywords: Adolescent, Child, Child, Preschool, Infant, Newborn, Intensive Care Units, Pediatric, Israel, Jews, Pediatrics