What is a Mortality Committee for? Autopsy as a quality indicator

Clicks: 3
ID: 317377
2026
Article Quality & Performance Metrics
Overall Quality
Not rated
Combines reader engagement with the AI quality analysis. This article has not been analysed, so there is no overall score — reader engagement is measured and shown alongside.
AI Quality Assessment
Not analyzed
Readership in this journal
Emerging

Ranked #102 of 111 articles by views in International journal for quality in health care : journal of the International Society for Quality in Health Care

Most read Least read

Bar heights use a square-root scale.

Mint this article as an NFT
Not yet minted

Create a permanent, verifiable on-chain record of this article on the Scimatic Network. The NFT is held in your Journament account, and you can withdraw it to your own wallet at any time.

5 SUSD one-off · no wallet required
Abstract
BACKGROUND: Clinical autopsy has played a central role in medical education, research, and quality assurance. Despite major advances in diagnostic technologies, clinically relevant discrepancies between premortem diagnoses and postmortem findings persist. However, declining autopsy rates have raised concerns about the loss of this tool as a marker of diagnostic accuracy and patient safety. Hospital Mortality Review Committees may help to integrate autopsy findings into quality improvement processes, although their real impact on clinical practice remains uncertain. We evaluate the contribution of clinical autopsies to the detection of major diagnostic discrepancies and examine how Hospital Mortality Review Committees may facilitate autopsy-based quality assessment in a tertiary care hospital. METHODS: A retrospective observational study of adult in-hospital deaths undergoing clinical autopsy over a 10-year period was conducted at a large tertiary hospital in Spain. Premortem clinical diagnoses were compared with postmortem findings using the modified Goldman classification. Major diagnostic discrepancies were analyzed overall and by clinical department. RESULTS: 284 clinical autopsies were analyzed. Major clinicopathological discrepancies were identified in 30.3% of cases. The most frequent missed diagnoses were malignancies, pneumonias, invasive fungal infections, aortic dissections, pulmonary embolism, and acute pancreatitis. Major discrepancies were most commonly observed in patients from the intensive care unit and internal medicine services. In 12.7% of cases, autopsy did not identify a definitive cause of death, particularly among critically ill and multimorbid patients. CONCLUSION: Major clinicopathological discrepancies (Goldman classes I-II) were identified in approximately one-third of autopsies, most commonly involving malignancies, infections, and cardiovascular diseases. Incorporation of autopsy findings allowed the identification of more clinically relevant diagnostic discrepancies than the initial clinical review alone. In this context, Hospital Mortality Review Committees may contribute to the systematic review of deaths and to the identification of potential areas for diagnostic and healthcare improvement. However, the low autopsy rate and the absence of structured feedback mechanisms may limit the translation of these findings into improvements in clinical practice and quality-of-care processes.
Reference Key
openalex_W7164838082 Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors Francisco Ortuño‐Andériz, María Jesús Fernández-Aceñero, Natividad Calvo Romero, Pacheco M V Acedo-Díaz, A Álvarez-Blanco, L F Ávila, N Calvo-Romero, J Dziakova, M J Fernández-Aceñero, C Ferrera, M I Galante-Romo, E J García-Lamberechts, M A González-Corchón, M J Jiménez-Martín, M Méndez-Bailón, F Ortuño-Andériz, N Pérez, M Rodríguez-Cerrillo, A Rodríguez-Moreno, Z Rosales-Rosado
Journal International journal for quality in health care : journal of the International Society for Quality in Health Care
Year 2026
DOI
10.1093/intqhc/mzag086
URL
Keywords Keywords not found

Citations

No citations found. To add a citation, contact the admin at info@scimatic.org

No comments yet. Be the first to comment on this article.