Premortem Clinical Diagnoses and Postmortem Autopsy Findings in Traumatic Cases: A Comparative Study

This study assessed the comparison of premortem and postmortem diagnoses of trauma cases that died during treatment and then autopsied. Autopsy reports of forensic cases which were referred to Gandhi Medical College & Hospital, Secunderabad between January 2011 and September 2014 were retrospectively reviewed. The cases that died because of trauma and which had complete medical reports were included in 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.