Concordance between clinical diagnoses and autopsies anatomopathological findings at a tertiary-level university hospital

Abstract

Introduction. A clinical autopsy is a fundamental diagnostic tool for confirming the diagnosis of diseases of public health interest. However, the clinical-pathological concordance has not been evaluated.
Objective. To determine the concordance between clinical diagnoses and anatomopathological findings from autopsies conducted at a tertiary-level hospital institution.
Materials and methods. A descriptive, observational, cross-sectional, and retrospective study where we analyzed autopsy cases performed between 2015 and 2019. The variables studied were age, gender, origin, and clinical and anatomopathological diagnoses.
Results. The concordance degree was slight (κ = 0.30; 95% CI: 0.21-0.42), which coincides with internationally reported findings in healthcare institutions with a similar patient population and availability of diagnostic resources. The clinical-pathological discrepancy, as evidenced according to the Goldman et al. classification, then modified by Battle et al., was 57.3% (47/82), corresponding to major discrepancies, a value within the expected limits.
Conclusions. The concordance between clinical diagnoses and anatomopathological findings in autopsies is slight, and the discrepancies are within the expected range. This study highlights the importance of improving clinical and syndromic diagnosis of public health interest.