Contemporary ReviewA systematic review of global autopsy rates in all-cause mortality and young sudden death
Graphical abstract
Section snippets
Background
Autopsy, the study of a body after death, is derived from the Greek word autopsia, meaning “to see for oneself.”1,2 Clinical (hospital) autopsy rates have been falling worldwide across recent decades3 due to multiple factors, including elimination of minimum autopsy requirements for accreditation, costs of autopsy, decreasing clinician request for autopsies, and increasing family and religious objection to autopsy.1,4, 5, 6 Forensic (medicolegal) autopsies, performed to investigate sudden or
Search strategy
A list of all countries of the world (n = 195) was obtained. Each country name and the search terms “autopsy,” “rate of autopsy,” “young sudden death,” and “young sudden death autopsy” were searched (Figure 1). Searches were conducted in PubMed and commercial search engines. Citation tracking also was utilized.
Inclusion criteria
Any document format was eligible for inclusion, including journal articles, publicly available governmental datasets, press releases, newspaper articles, and annual reports. Included data
Results
All 195 countries in the world were assessed for reports of autopsy rate in sudden cardiac death or overall death (Supplemental Table 3).
Discussion
This study identified that, despite the central role of the autopsy in determining cause of death, global rates of autopsy are very poorly understood. Over two-thirds of countries do not provide any publicly accessible data regarding their autopsy rates, and >90% of countries provide no information regarding autopsy rates in young SD. Without clear reporting of autopsy rates, any comparison of reported global causes of death is inherently flawed.
Conclusion
Although autopsy is the gold standard method of determining cause of death, most countries globally do not report autopsy rates in either all-cause death (69.7%) or in SD (92.8%). Without transparent reporting of autopsy rates, global burden of disease and rates of sudden cardiac death cannot be reliably calculated.
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Cited by (0)
Funding Sources: Dr Paratz is supported by an NHMRC/NHF co-funded Postgraduate Scholarship, RACP JJ Billings Scholarship, and PSA Cardiovascular Scholarship. Dr La Gerche is supported by an NHF Future Leadership Fellowship and NHMRC Career Development Fellowship. Dr Stub is supported by an NHF Future Leadership Fellowship. Disclosures: The authors have no conflicts of interest to disclose.