Analysis of the structure of lethality in a multi-profile hospital by the data of an Anatomic Pathology Department
To assess the effectiveness of the work of a medical institution, it is necessary to analyze the quality of clinical diagnostics and compare clinical and pathoanatomic diagnoses. The purpose - to conduct a retrospective analysis of mortality in a multi-profile hospital by gender, age and nosological forms over the past 10 years. Material and methods. The data of 2195 protocols of postmortem pathoanatomic examination were studied, with the analysis of clinical and pathoanatomic diagnoses and taking into account the sex and age of deceased patients. The patients were divided into three age groups: young (up to 55 years old), elderly (56-70 years old) and senile (over 70 years old). Based on the finalpathoanatomic diagnosis, the deceased patients were divided by nosology into 11 groups. Results. Over 10 years (2012-2021), 3731 people died in the hospital; 2195 of them (66.7%) were sent for a pathoanatomical autopsy. The frequency of discrepancy between clinical and pathoanatomic diagnoses averaged 6.7% (in 2012-2017), and over the past four years this percentage has fallen to almost zero. The analysis of mortality by nosological forms showed that cardiovascular diseases were found in 54.8% of all autopsies. The numbers of deaths in men and women were similar in almost all groups, only men had 1.5 times more repeated myocardial infarctions, and women were more often (1.5 times) diagnosed with diabetes as the main cause of death. It should be noted that diabetes, as a concomitant disease, was detected in every third patient in all groups, regardless of gender. In the group of oncological diseases, the leading position is occupied by colon cancer, which accounted for 37.7% of all tumors in men, while in women colon cancer was detected in 36.7% of deceased patients.