Dataset Information

Hospital implementation of minimally invasive autopsy: A prospective cohort study of clinical performance and costs.

ABSTRACT:

Objectives

Autopsy rates worldwide have dropped significantly over the last decades and imaging-based autopsies are increasingly used as an alternative to conventional autopsy. Our aim was to evaluate the clinical performance and cost of minimally invasive autopsy.

Methods

This study was part of a prospective cohort study evaluating a newly implemented minimally invasive autopsy consisting of MRI, CT, and biopsies. We calculated diagnostic yield and clinical utility-defined as the percentage successfully answered clinical questions-of minimally invasive autopsy. We performed minimally invasive autopsy in 46 deceased (30 men, 16 women; mean age 62.9±17.5, min-max: 18-91).

Results

Ninety-six major diagnoses were found with the minimally invasive autopsy of which 47/96 (49.0%) were new diagnoses. CT found 65/96 (67.7%) major diagnoses and MRI found 82/96 (85.4%) major diagnoses. Eighty-four clinical questions were asked in all cases. Seventy-one (84.5%) of these questions could be answered with minimally invasive autopsy. CT successfully answered 34/84 (40.5%) clinical questions; in 23/84 (27.4%) without the need for biopsies, and in 11/84 (13.0%) a biopsy was required. MRI successfully answered 60/84 (71.4%) clinical questions, in 27/84 (32.1%) without the need for biopsies, and in 33/84 (39.8%) a biopsy was required. The mean cost of a minimally invasive autopsy was €1296 including brain biopsies and €1087 without brain biopsies. Mean cost of CT was €187 and of MRI €284.

Conclusions

A minimally invasive autopsy, consisting of CT, MRI and CT-guided biopsies, performs well in answering clinical questions and detecting major diagnoses. However, the diagnostic yield and clinical utility were quite low for postmortem CT and MRI as standalone modalities.

SUBMITTER: Wagensveld IM

PROVIDER: S-EPMC6634385 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature

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Publications

Hospital implementation of minimally invasive autopsy: A prospective cohort study of clinical performance and costs.

Wagensveld Ivo M IM Hunink M G Myriam MGM Wielopolski Piotr A PA van Kemenade Folkert J FJ Krestin Gabriel P GP Blokker Britt M BM Oosterhuis J Wolter JW Weustink Annick C AC

PloS one 20190716 7

<h4>Objectives</h4>Autopsy rates worldwide have dropped significantly over the last decades and imaging-based autopsies are increasingly used as an alternative to conventional autopsy. Our aim was to evaluate the clinical performance and cost of minimally invasive autopsy.<h4>Methods</h4>This study was part of a prospective cohort study evaluating a newly implemented minimally invasive autopsy consisting of MRI, CT, and biopsies. We calculated diagnostic yield and clinical utility-defined as the ...[more]

PMID: 31310623

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Dataset Information

Hospital implementation of minimally invasive autopsy: A prospective cohort study of clinical performance and costs.

Objectives

Methods

Results

Conclusions

Publications

Hospital implementation of minimally invasive autopsy: A prospective cohort study of clinical performance and costs.

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