PDF(Pubmed)
Abstract：
The postmortem examination can be used as a means of quality control for clinical diagnoses. A retrospective study on 300 dogs and cats that had been admitted to a small animal intensive care unit was performed comparing the clinical and postmortem findings, using the Modified Goldman criteria. All patient files were reevaluated for clinical diagnoses and all postmortem material was reevaluated for pathological diagnoses. After this, the Modified Goldman criteria were applied to score the discrepancies between them, and factors associated with the occurrence of an undiagnosed major unexpected finding were analyzed. The postmortem examination revealed additional findings in 65% of the cases. Major discrepancies, defined as those affecting treatment and possibly outcome of the patient, were present in 21.3% of the cases. The most frequently missed diagnoses detected at necropsy were pneumonia of various etiologies, meningitis/meningoencephalitis, myocarditis and generalized vasculitis. A shorter ICU stay was associated with increased odds of a major discrepancy. Conditions affecting the urinary or gastrointestinal system were negatively associated with major discrepancy.
摘要：
验尸可用作临床诊断的质量控制手段。对已入住小型动物重症监护病房的300只狗和猫进行了回顾性研究，比较了临床和尸检结果，使用修改后的高盛标准。重新评估所有患者档案以进行临床诊断，并重新评估所有死后材料以进行病理诊断。在这之后,修改后的高盛标准被用来对它们之间的差异进行评分，并分析了与未诊断的重大意外发现发生相关的因素。验尸显示，在65％的病例中发现了其他发现。重大差异,定义为影响患者治疗和可能的结果的那些，在21.3%的病例中。尸检时最常见的漏诊是各种病因的肺炎，脑膜炎/脑膜脑炎，心肌炎和全身性血管炎。ICU住院时间较短与出现重大差异的可能性增加有关。影响泌尿或胃肠道系统的疾病与主要差异呈负相关。
