A Comparison between Premortem and Postmortem Diagnosis in Trauma Cases


This study evaluated the comparison of premortem and postmortem diagnoses of trauma cases that died during treatment and then autopsied. We had analyzed the autopsy reports of forensic deaths retrospectively which occurred between 2013 and 2014. The cases that died because of trauma and which had complete medical reports were included the study. Totally 626 cases were autopsied and 307 cases records were examined from them. The mean age was found to be 28.11. According the treatment period, it was detected that 116 (37.8%) cases died within the first 24 hours. Discrepancies between premortem and postmortem diagnoses were determined in 20.6% of cases. 5.9% had a main diagnostic discrepancy and 14.7% were of second lethal diagnoses. The discrepancies were observed mostly in the multiple injury cases. In our study, diagnostic discrepancy rate was higher in multiple injury cases especially who died by explosion. When clinicians focus on the treatment according to their main diagnosis, they overlook the fatal injuries in other parts of the body. This study shows that autopsy is the most reliable method for the confirmation of the clinical diagnosis in trauma patients. Therefore, particularly surgery physicians should compare the results of the autopsy diagnoses to their own diagnosis.

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Demirkiran, D. , Ortanca, I. , Sahan, M. , Celikel, A. and Arslan, M. (2015) A Comparison between Premortem and Postmortem Diagnosis in Trauma Cases. Forensic Medicine and Anatomy Research, 3, 89-94. doi: 10.4236/fmar.2015.34015.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] Roulson, J., Benbow, E.W. and Hasleton, P.S. (2005) Discrepancies between Clinical and Autopsy Diagnosis and the Value of Post Mortem Histology; a Meta-Analysis and Review. Histopathology, 47, 551-559.
[2] McGoogan, E. and Cameron, H.M. (1978) Clinical Attitudes to the Autopsy. Scottish Medical Journal, 23, 19-22.
[3] Juvin, P., Teissière, F., Brion, F., Desmonts, J.M. and Durigon, M. (2000) Postoperative Death and Malpractice Suits: Is Autopsy Useful? Anesthesia & Analgesia, 91, 344-346.
[4] Ermenc, B. (2000) Comparison of the Clinical and Post Mortem Diagnoses of the Causes of Death. Forensic Science International, 114, 117-119. http://dx.doi.org/10.1016/S0379-0738(00)00329-7
[5] Goldman, L., Sayson, R., Robbins, S., Cohn, L.H., Bettmann, M. and Weisberg, M. (1983) The Value of the Autopsy in Three Different Eras. The New England Journal of Medicine, 308, 1000-1005.
[6] Cameron, H.M. (1981) The Autopsy as a Clinical Investigation. Journal of the Royal Society of Medicine, 74, 713-715.
[7] Cameron, H.M., McGoogan, E. and Watson, H. (1980) Necropsy: A Yardstick for Clinical Diagnosis. British Medical Journal, 281, 985-988. http://dx.doi.org/10.1136/bmj.281.6246.985
[8] Yayci, N., üzün, I., Arslan, M.M. and Iris, M. (2004) Postoperatif Ölümle Sonuçlanmisve Tibbi Uygulama Hatasi Iddiasi Bulunan Olgularda Otopsinin Degeri. Türkiye Klinikleri Adli Tip Dergisi, 1, 57-61.
[9] Pakis, I., Polat, O., Yayci, N. and Karapirli, M. (2010) Comparison of the Clinical Diagnosis and Subsequent Autopsy Findings in Medical Malpractice. American Journal of Forensic Medicine & Pathology, 31, 218-221.
[10] Battle, R.M., Pathak, D. and Humble, C.G. (1987) Factors Influencing Discrepancies between Premortem and Postmortem Diagnosis. JAMA, 258, 339-344.
[11] Mosquera, D.A. and Goldman, M.D. (1993) Surgical Audit without Autopsy: Tales of the Unexpected. Ann R CollSurg Engl, 75, 115-117.
[12] Kirch, W. and Schafii, C. (1996) Misdiagnosis at a University Hospital in 4 Medical Eras. Medicine (Baltimore), 75, 29-40. http://dx.doi.org/10.1097/00005792-199601000-00004
[13] Coradazzi, A.L., Morganti, A.L. and Montenegro, M.R. (2003) Discrepancies between Clinical Diagnoses and Autopsy Findings. Brazilian Journal of Medical and Biological Research, 36, 385-391.
[14] Stevanovic, G., Tucakovic, G., Dotlic, R.D. and Kanjuh, V. (1986) Correlation of Clinical Diagnoses and Autopsy Findings: A Retrospective Study of 2145 Consecutive Autopsies. Human Pathology, 17, 1225-1230. http://dx.doi.org/10.1016/S0046-8177(86)80564-0
[15] Tai, D.Y., El-Bilbeisi, H., Tewari, S., Mascha, E.J., Wiedemann, H.P. and Arroliga, A.C. (2001) A Study of Consecutive Autopsies in a Medical ICU. A Comparison of Clinical Cause of Death and Autopsy Diagnosis. Chest, 119, 530- 536. http://dx.doi.org/10.1378/chest.119.2.530
[16] Holcomb, J., Caruso, J., McMullin, N., Wade, C.E., Pearse, L., Oetjen-Gerdes, L., Champion, H.R., Lawnick, M., Farr, W., Rodriguez, S. and Butler, F. (2007) Causes of Death in US Special Operations Forces in the Global War on Terrorism: 2001-2004. U.S. Army Medical Department Journal, 24-37.
[17] Eyi, Y.E., Toygar, M., Karbeyaz, K., Kaldirim, ü., Tuncer, S.K. and Durusu, M. (2015) Evaluation of Autopsy Reports in Terms of Preventability of Traumatic Deaths. Ulusal Travma ve Acil Cerrahi Dergisi, 2, 127-133.

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