Advertisement

A quarter century of decline of autopsies in the Netherlands

  • Bartholomeus G. H. LattenEmail author
  • Lucy I. H. Overbeek
  • Bela Kubat
  • Axel zur Hausen
  • Leo J. Schouten
LETTER TO THE EDITOR
  • 27 Downloads

Abstract

Objective

Autopsy rates have been declining worldwide. The present study reports the outcome of a retrospective analysis of all non-forensic autopsies in the Netherlands over a course of 25 years, and compares these with the most recent Dutch study.

Method

Retrospectively, 25 years of data on clinical autopsies from the Nationwide Network and Registry of Histo- and Cytopathology in the Netherlands (PALGA) was paired with the mortality registry (Statistics Netherlands).

Results

The crude prevalence of autopsies declined from 7.07% in 1991 to 2.73% in 2015. After adjusting for age at death, there was no difference in autopsy rate between males and females. An increasing age significantly decreased the autopsy rate.

Conclusion

In the Netherlands, clinical autopsies have been declining over the last quarter century. Age at death, but not sex, was associated with the autopsy rate. These different results stress the importance of correct collection and analysis methods of data.

Keywords

Autopsy rate Quality control Autopsy 

Notes

Supplementary material

10654_2019_572_MOESM1_ESM.docx (44 kb)
Supplementary material 1 (DOCX 44 kb)

References

  1. 1.
    Burton JL, Underwood J. Clinical, educational, and epidemiological value of autopsy. Lancet. 2007;369(9571):1471–80.CrossRefGoogle Scholar
  2. 2.
    Turnbull A, Osborn M, Nicholas N. Hospital autopsy: endangered or extinct? J Clin Pathol. 2015;68(8):601–4.CrossRefGoogle Scholar
  3. 3.
    Raut A, Andrici J, Severino A, Gill AJ. The death of the hospital autopsy in Australia? The hospital autopsy rate is declining dramatically. Pathology. 2016;48(7):645–9.CrossRefGoogle Scholar
  4. 4.
    Gaensbacher S, Waldhoer T, Berzlanovich A. The slow death of autopsies: a retrospective analysis of the autopsy prevalence rate in Austria from 1990 to 2009. Eur J Epidemiol. 2012;27(7):577–80.CrossRefGoogle Scholar
  5. 5.
    Grassow-Narlik M, Wessolly M, Friemann J. Autopsy rates in Germany. Pathologe. 2017;38(5):422–9.CrossRefGoogle Scholar
  6. 6.
    Kuijpers CC, Fronczek J, van de Goot FR, Niessen HW, van Diest PJ, Jiwa M. The value of autopsies in the era of high-tech medicine: discrepant findings persist. J Clin Pathol. 2014;67(6):512–9.CrossRefGoogle Scholar
  7. 7.
    Wittschieber D, Klauschen F, Kimmritz AC, von Winterfeld M, Kamphues C, Scholman HJ, et al. Who is at risk for diagnostic discrepancies? Comparison of pre- and postmortal diagnoses in 1800 patients of 3 medical decades in East and West Berlin. PLoS ONE. 2012;7(5):e37460.CrossRefGoogle Scholar
  8. 8.
    Schwanda-Burger S, Moch H, Muntwyler J, Salomon F. Diagnostic errors in the new millennium: a follow-up autopsy study. Mod Pathol. 2012;25(6):777–83.CrossRefGoogle Scholar
  9. 9.
    Shojania KG, Burton EC, McDonald KM, Goldman L. Changes in rates of autopsy-detected diagnostic errors over time: a systematic review. JAMA. 2003;289(21):2849–56.CrossRefGoogle Scholar
  10. 10.
    Blokker BM, Weustink AC, Hunink MGM, Oosterhuis JW. Autopsy rates in the Netherlands: 35 years of decline. PLoS ONE. 2017;12(6):e0178200.CrossRefGoogle Scholar
  11. 11.
  12. 12.
    Casparie M, Tiebosch AT, Burger G, Blauwgeers H, van de Pol A, van Krieken JH, et al. Pathology databanking and biobanking in The Netherlands, a central role for PALGA, the nationwide histopathology and cytopathology data network and archive. Cell Oncol. 2007;29(1):19–24.PubMedPubMedCentralGoogle Scholar
  13. 13.
    Kim HJ, Fay MP, Feuer EJ, Midthune DN. Permutation tests for joinpoint regression with applications to cancer rates. Stat Med. 2000;19(3):335–51.CrossRefGoogle Scholar
  14. 14.
    van den Tweel JG, Wittekind C. The medical autopsy as quality assurance tool in clinical medicine: dreams and realities. Virchows Arch. 2016;468(1):75–81.CrossRefGoogle Scholar
  15. 15.
    Smits CH, van den Beld HK, Aartsen MJ, Schroots JJ. Aging in the Netherlands: state of the art and science. Gerontologist. 2014;54(3):335–43.CrossRefGoogle Scholar

Copyright information

© Springer Nature B.V. 2019

Authors and Affiliations

  1. 1.Department of PathologyMaastricht University Medical CentreMaastrichtThe Netherlands
  2. 2.Donders Center of Medical NeurosciencesRadboud UniversityNijmegenThe Netherlands
  3. 3.Department of EpidemiologyMaastricht UniversityMaastrichtThe Netherlands

Personalised recommendations