GS09 AUTOPSY IN GENERAL SURGERY: A COMPARISON OF PRACTICE AND OPINION

Objective  To examine current practice regarding autopsy requests and assess consultant opinion in a general surgical department. Methods  100 patient deaths in a general surgical department, over a 2 year period, were randomly selected. A brief summary of each admission was distributed to 13 general surgeons who were asked to comment whether; cases should have been discussed with the coroner, a coroner’s autopsy should have been performed, a hospital post mortem should have been performed and whether it would be appropriate to complete a death certificate without post mortem. Surgeon responses were compared with actual outcomes. Results  The majority of patients were elderly (median age 79 yrs, 49% > 80 yrs), admitted acutely (92%) and did not undergo an operation (73%). Patients who had undergone recent operation were more likely to be referred to the coroner (p < 0.001) and more likely to undergo coroners autopsy (p = 0.011). Older patients and those admitted from a rest home were less likely to be referred to the coroner (p < 0.001 & 0.02 respectively) or undergo coroners autopsy (p = 0.002). The survey predicted more referrals to the coroner (p = 0.001), more hospital autopsies (p < 0.001), and that the treating doctor would complete the certificate of death less often than actually happened (p = 0.004). Conclusions  General surgeons consider autopsy to be necessary more often than current practice in our institution. The decline in autopsy rates may compromise the education of surgeons and trainees.