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Virtual autopsy with multiphase postmortem computed tomographic angiography versus traditional medical autopsy to investigate unexpected deaths of hospitalized patients: a cohort study

Standard

Virtual autopsy with multiphase postmortem computed tomographic angiography versus traditional medical autopsy to investigate unexpected deaths of hospitalized patients: a cohort study. / Wichmann, Dominic; Heinemann, Axel; Weinberg, Clemens; Vogel, Hermann; Hoepker, Wilhelm Wolfgang; Grabherr, Silke; Püschel, Klaus; Kluge, Stefan.

In: ANN INTERN MED, Vol. 160, No. 8, 15.04.2014, p. 534-41.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Wichmann, D, Heinemann, A, Weinberg, C, Vogel, H, Hoepker, WW, Grabherr, S, Püschel, K & Kluge, S 2014, 'Virtual autopsy with multiphase postmortem computed tomographic angiography versus traditional medical autopsy to investigate unexpected deaths of hospitalized patients: a cohort study', ANN INTERN MED, vol. 160, no. 8, pp. 534-41. https://doi.org/10.7326/M13-2211

APA

Wichmann, D., Heinemann, A., Weinberg, C., Vogel, H., Hoepker, W. W., Grabherr, S., Püschel, K., & Kluge, S. (2014). Virtual autopsy with multiphase postmortem computed tomographic angiography versus traditional medical autopsy to investigate unexpected deaths of hospitalized patients: a cohort study. ANN INTERN MED, 160(8), 534-41. https://doi.org/10.7326/M13-2211

Vancouver

Wichmann D, Heinemann A, Weinberg C, Vogel H, Hoepker WW, Grabherr S et al. Virtual autopsy with multiphase postmortem computed tomographic angiography versus traditional medical autopsy to investigate unexpected deaths of hospitalized patients: a cohort study. ANN INTERN MED. 2014 Apr 15;160(8):534-41. https://doi.org/10.7326/M13-2211

Bibtex

@article{8f10c3adcba64ccdbd32bfbdd162ce92,
title = "Virtual autopsy with multiphase postmortem computed tomographic angiography versus traditional medical autopsy to investigate unexpected deaths of hospitalized patients: a cohort study",
abstract = "BACKGROUND: {"}Virtual{"} autopsy by postmortem computed tomography (PMCT) can replace medical autopsy to a certain extent but has limitations for cardiovascular diseases. These limitations might be overcome by adding multiphase PMCT angiography.OBJECTIVE: To compare virtual autopsy by multiphase PMCT angiography with medical autopsy.DESIGN: Prospective cohort study. (ClinicalTrials.gov: NCT01541995) SETTING: Single-center study at the University Medical Center Hamburg-Eppendorf, Hamburg, Germany, between 1 April 2012 and 31 March 2013.PATIENTS: Hospitalized patients who died unexpectedly or within 48 hours of an event necessitating cardiopulmonary resuscitation.MEASUREMENTS: Diagnoses from clinical records were compared with findings from both types of autopsy. New diagnoses identified by autopsy were classified as major or minor, depending on whether they would have altered clinical management.RESULTS: Of 143 eligible patients, 50 (35%) had virtual and medical autopsy. Virtual autopsy confirmed 93% of all 336 diagnoses identified from antemortem medical records, and medical autopsy confirmed 80%. In addition, virtual and medical autopsy identified 16 new major and 238 new minor diagnoses. Seventy-three of the virtual autopsy diagnoses, including 32 cases of coronary artery stenosis, were identified solely by multiphase PMCT angiography. Of the 114 clinical diagnoses classified as cardiovascular, 110 were confirmed by virtual autopsy and 107 by medical autopsy. In 11 cases, multiphase PMCT angiography showed {"}unspecific filling defects,{"} which were not reported by medical autopsy.LIMITATION: These results come from a single center with concerted interest and expertise in postmortem imaging; further studies are thus needed for generalization.CONCLUSION: In cases of unexpected death, the addition of multiphase PMCT angiography increases the value of virtual autopsy, making it a feasible alternative for quality control and identification of diagnoses traditionally made by medical autopsy.PRIMARY FUNDING SOURCE: University Medical Center Hamburg-Eppendorf.",
keywords = "Adult, Aged, Aged, 80 and over, Angiography, Autopsy, Cardiovascular Diseases, Cause of Death, Death, Sudden, Female, Hospital Mortality, Humans, Imaging, Three-Dimensional, Male, Middle Aged, Prospective Studies, Tomography, X-Ray Computed",
author = "Dominic Wichmann and Axel Heinemann and Clemens Weinberg and Hermann Vogel and Hoepker, {Wilhelm Wolfgang} and Silke Grabherr and Klaus P{\"u}schel and Stefan Kluge",
year = "2014",
month = apr,
day = "15",
doi = "10.7326/M13-2211",
language = "English",
volume = "160",
pages = "534--41",
journal = "ANN INTERN MED",
issn = "0003-4819",
publisher = "American College of Physicians",
number = "8",

}

RIS

TY - JOUR

T1 - Virtual autopsy with multiphase postmortem computed tomographic angiography versus traditional medical autopsy to investigate unexpected deaths of hospitalized patients: a cohort study

AU - Wichmann, Dominic

AU - Heinemann, Axel

AU - Weinberg, Clemens

AU - Vogel, Hermann

AU - Hoepker, Wilhelm Wolfgang

AU - Grabherr, Silke

AU - Püschel, Klaus

AU - Kluge, Stefan

PY - 2014/4/15

Y1 - 2014/4/15

N2 - BACKGROUND: "Virtual" autopsy by postmortem computed tomography (PMCT) can replace medical autopsy to a certain extent but has limitations for cardiovascular diseases. These limitations might be overcome by adding multiphase PMCT angiography.OBJECTIVE: To compare virtual autopsy by multiphase PMCT angiography with medical autopsy.DESIGN: Prospective cohort study. (ClinicalTrials.gov: NCT01541995) SETTING: Single-center study at the University Medical Center Hamburg-Eppendorf, Hamburg, Germany, between 1 April 2012 and 31 March 2013.PATIENTS: Hospitalized patients who died unexpectedly or within 48 hours of an event necessitating cardiopulmonary resuscitation.MEASUREMENTS: Diagnoses from clinical records were compared with findings from both types of autopsy. New diagnoses identified by autopsy were classified as major or minor, depending on whether they would have altered clinical management.RESULTS: Of 143 eligible patients, 50 (35%) had virtual and medical autopsy. Virtual autopsy confirmed 93% of all 336 diagnoses identified from antemortem medical records, and medical autopsy confirmed 80%. In addition, virtual and medical autopsy identified 16 new major and 238 new minor diagnoses. Seventy-three of the virtual autopsy diagnoses, including 32 cases of coronary artery stenosis, were identified solely by multiphase PMCT angiography. Of the 114 clinical diagnoses classified as cardiovascular, 110 were confirmed by virtual autopsy and 107 by medical autopsy. In 11 cases, multiphase PMCT angiography showed "unspecific filling defects," which were not reported by medical autopsy.LIMITATION: These results come from a single center with concerted interest and expertise in postmortem imaging; further studies are thus needed for generalization.CONCLUSION: In cases of unexpected death, the addition of multiphase PMCT angiography increases the value of virtual autopsy, making it a feasible alternative for quality control and identification of diagnoses traditionally made by medical autopsy.PRIMARY FUNDING SOURCE: University Medical Center Hamburg-Eppendorf.

AB - BACKGROUND: "Virtual" autopsy by postmortem computed tomography (PMCT) can replace medical autopsy to a certain extent but has limitations for cardiovascular diseases. These limitations might be overcome by adding multiphase PMCT angiography.OBJECTIVE: To compare virtual autopsy by multiphase PMCT angiography with medical autopsy.DESIGN: Prospective cohort study. (ClinicalTrials.gov: NCT01541995) SETTING: Single-center study at the University Medical Center Hamburg-Eppendorf, Hamburg, Germany, between 1 April 2012 and 31 March 2013.PATIENTS: Hospitalized patients who died unexpectedly or within 48 hours of an event necessitating cardiopulmonary resuscitation.MEASUREMENTS: Diagnoses from clinical records were compared with findings from both types of autopsy. New diagnoses identified by autopsy were classified as major or minor, depending on whether they would have altered clinical management.RESULTS: Of 143 eligible patients, 50 (35%) had virtual and medical autopsy. Virtual autopsy confirmed 93% of all 336 diagnoses identified from antemortem medical records, and medical autopsy confirmed 80%. In addition, virtual and medical autopsy identified 16 new major and 238 new minor diagnoses. Seventy-three of the virtual autopsy diagnoses, including 32 cases of coronary artery stenosis, were identified solely by multiphase PMCT angiography. Of the 114 clinical diagnoses classified as cardiovascular, 110 were confirmed by virtual autopsy and 107 by medical autopsy. In 11 cases, multiphase PMCT angiography showed "unspecific filling defects," which were not reported by medical autopsy.LIMITATION: These results come from a single center with concerted interest and expertise in postmortem imaging; further studies are thus needed for generalization.CONCLUSION: In cases of unexpected death, the addition of multiphase PMCT angiography increases the value of virtual autopsy, making it a feasible alternative for quality control and identification of diagnoses traditionally made by medical autopsy.PRIMARY FUNDING SOURCE: University Medical Center Hamburg-Eppendorf.

KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - Angiography

KW - Autopsy

KW - Cardiovascular Diseases

KW - Cause of Death

KW - Death, Sudden

KW - Female

KW - Hospital Mortality

KW - Humans

KW - Imaging, Three-Dimensional

KW - Male

KW - Middle Aged

KW - Prospective Studies

KW - Tomography, X-Ray Computed

U2 - 10.7326/M13-2211

DO - 10.7326/M13-2211

M3 - SCORING: Journal article

C2 - 24733194

VL - 160

SP - 534

EP - 541

JO - ANN INTERN MED

JF - ANN INTERN MED

SN - 0003-4819

IS - 8

ER -