Autopsy proven causes of in hospital mortality in acute stroke

Abstract To characterize discrepancies between the causes of death as determined by the clinician and autopsy findings in patients admitted with stroke, we retrospectively reviewed all autopsies on patients died with a diagnosis of stroke. Fifty-eight patients with a diagnosis of stroke died after admission to our tertiary medical center in the past ten years were autopsied. Strokes included ischemic strokes, hemorrhagic strokes and subarachnoid hemorrhages. Thirty-five had complete autopsy and twenty-three patients had autopsy limited to brain only examination. We reviewed the autopsy findings and correlated them to the clinical diagnoses that were extracted from the clinical records. We looked particularly for major discrepancies that could have altered treatment strategies. Discrepancies between clinical diagnoses and autopsy findings were classified into major and minor using the Goldman et al. criteria. Only in three instances there were major discrepancies and therapy may have altered medical management in one of these.