Erratum: The Value of Neonatal Autopsy

<i>Background and Objective:</i> Neonatal autopsy rates were in decline internationally at the end of the last century. Our objective was to assess the current value of neonatal autopsy in providing additional information to families and healthcare professionals. <i>Methods:</i> We conducted a review of neonatal autopsies performed in a tertiary perinatal centre over an 11-year period. Primary outcomes measured were the annual neonatal autopsy rates and concordance rates between clinical and autopsy diagnoses of the primary cause of death. Secondary outcomes were the clinical, genetic and audit value of the examinations. Findings were used to inform the consent process, and the effect this had on institutional post-mortem rates was assessed over the subsequent 5-year period. <i>Results:</i> There was a marked decline in the annual neonatal autopsy rate from 73% in 1994 to 48% in 2004. 164 cases met the inclusion criteria for review. Complete concordance for cause of death was reached in 91% of cases. Previously unsuspected or unconfirmed clinical conditions, other than the primary cause of death, were uncovered at autopsy in 85 cases. Detailed information on inheritable conditions was obtained in 45 cases. Findings with perceived ‘audit value’ for clinical practice were identified in 29 cases. The dissemination of this information to staff and families contributed to the stabilisation of the consent rate in the following 5-year period. <i>Conclusion:</i> Neonatal autopsy remains a valuable diagnostic tool as it provides critical clinical and audit information for healthcare professionals and families.

【背景与目的】
上世纪末，全球新生儿尸检（neonatal autopsy）率呈持续下降趋势。本研究旨在评估当前新生儿尸检在为患儿家属及医护人员提供补充信息方面的价值。
【研究方法】
本研究对某三级围产中心（tertiary perinatal centre）11年间开展的新生儿尸检进行回顾性分析。主要结局指标为年度新生儿尸检率，以及临床诊断与尸检诊断的主要死亡原因符合率。次要结局指标包括该检查的临床价值、遗传学价值及医疗质量审计价值。研究结果被用于优化尸检知情同意流程，并评估其在随后5年间对机构尸检率的影响。
【研究结果】
年度新生儿尸检率从1994年的73%显著降至2004年的48%。本研究共纳入164例符合纳入标准的病例。其中91%的病例的死亡原因诊断与尸检结果完全相符。尸检共发现85例此前未被临床怀疑或未确诊的、非主要死亡原因相关的临床病症。在45例病例中获取了遗传性病症的详细信息。另有29例病例的尸检结果被认为具备临床实践质量审计价值。将该研究结果向医护人员及患儿家属公示后，使得后续5年间的尸检知情同意率趋于稳定。
【结论】
新生儿尸检仍是极具价值的诊断工具，可为医护人员及患儿家属提供关键的临床与医疗质量审计相关信息。