Postmortem Interval and Diagnostic Performance of the Autopsy Methods
Por:
Hurtado JC, Quintó L, Castillo P, Carrilho C, Fernandes F, Jordao D, Lovane L, Navarro M, Casas I, Bene R, Nhampossa T, Santos Ritchie P, Bandeira S, Sambo C, Chicamba V, Mocumbi S, Jaze Z, Mabota F, Ismail MR, Lorenzoni C, Guisseve A, Rakislova N, Marimon L, Castrejon N, Sanz A, Cossa A, Mandomando I, Munguambe K, Maixenchs M, Munoz-Almagro C, Macete E, Alonso P, Vila J, Bassat Q, Menéndez C, Martínez MJ and Ordi J
Publicada:
31 oct 2018
Ahead of Print:
31 oct 2018
Categoría:
Multidisciplinary
Resumen:
Postmortem studies, including the complete diagnostic autopsy (CDA) and the minimally invasive autopsy (MIA), an innovative approach to post-mortem sampling and cause of death investigation, are commonly performed within 24 hours after death because the quality of the tissues deteriorates over time. This short timeframe may hamper the feasibility of the procedure. In this study, we compared the diagnostic performance of the two postmortem procedures when carried out earlier and later than 24 hours after death, as well as the impact of increasing postmortem intervals (PMIs) on the results of the microbiological tests in a series of 282 coupled MIA/CDA procedures performed at the Maputo Central Hospital in Mozambique between 2013 and 2015. 214 procedures were conducted within 24 hours of death (early autopsies), and 68 after 24 hours of death (late autopsies). No significant differences were observed in the number of non-conclusive diagnoses (2/214 [1%] vs. 1/68 [1%] p = 0.5645 for the CDA; 27/214 [13%] vs. 5/68 [7%] p = 0.2332 for the MIA). However, increasing PMIs were associated with a raise in the number of bacteria identified (rate: 1.014 per hour [95% CI: 1.002-1.026]; p = 0.0228). This increase was mainly due to rising numbers of bacteria of the Enterobacteriaceae family and Pseudomonas genus strains. Thus, performing MIA or CDA more than 24 hours after death can still render reliable diagnostic results, not only for non-infectious conditions but also for many infectious diseases, although, the contribution of Enterobacteriaceae and Pseudomonas spp. as etiological agents of infections leading to death may be overestimated.
Filiaciones:
Hurtado JC:
ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
Department of Microbiology, Hospital Clinic - Universitat de Barcelona, Barcelona, Spain
Quintó L:
ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
Castillo P:
ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
Department of Pathology, Hospital Clinic - Universitat de Barcelona, Barcelona, Spain
Carrilho C:
Department of Pathology, Maputo Central Hospital, Maputo, Mozambique
Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique
Fernandes F:
Department of Pathology, Maputo Central Hospital, Maputo, Mozambique
Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique
Jordao D:
Department of Pathology, Maputo Central Hospital, Maputo, Mozambique
Lovane L:
Department of Pathology, Maputo Central Hospital, Maputo, Mozambique
Navarro M:
ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
Department of Microbiology, Hospital Clinic - Universitat de Barcelona, Barcelona, Spain
Casas I:
ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
Department of Microbiology, Hospital Clinic - Universitat de Barcelona, Barcelona, Spain
Bene R:
Department of Medicine, Maputo Central Hospital, Maputo, Mozambique
Nhampossa T:
Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique
Santos Ritchie P:
Department of Pediatrics, Maputo Central Hospital, Maputo, Mozambique
Bandeira S:
Department of Pediatrics, Maputo Central Hospital, Maputo, Mozambique
Sambo C:
Department of Pediatrics, Maputo Central Hospital, Maputo, Mozambique
Chicamba V:
Department of Pediatrics, Maputo Central Hospital, Maputo, Mozambique
Mocumbi S:
Department of Gynecology and Obstetrics, Maputo Central Hospital, Maputo, Mozambique
Jaze Z:
Department of Gynecology and Obstetrics, Maputo Central Hospital, Maputo, Mozambique
Mabota F:
Department of Gynecology and Obstetrics, Maputo Central Hospital, Maputo, Mozambique
Ismail MR:
Department of Pathology, Maputo Central Hospital, Maputo, Mozambique
Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique
Lorenzoni C:
Department of Pathology, Maputo Central Hospital, Maputo, Mozambique
Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique
Guisseve A:
Department of Pathology, Maputo Central Hospital, Maputo, Mozambique
Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique
Rakislova N:
ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
Department of Pathology, Hospital Clinic - Universitat de Barcelona, Barcelona, Spain
Marimon L:
ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
Department of Pathology, Hospital Clinic - Universitat de Barcelona, Barcelona, Spain
Castrejon N:
Department of Pathology, Hospital Clinic - Universitat de Barcelona, Barcelona, Spain
Sanz A:
Department of Microbiology, Hospital Clinic - Universitat de Barcelona, Barcelona, Spain
Cossa A:
Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique
Mandomando I:
Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique
Munguambe K:
Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique
Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique
Maixenchs M:
ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique
Munoz-Almagro C:
Department of Molecular Microbiology, University Hospital Sant Joan de Déu (University of Barcelona), Barcelona, Spain
Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
Faculty of Medicine, Univesitat Internacional de Catalunya, Barcelona, Spain
Macete E:
Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique
Alonso P:
ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique
Vila J:
ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
Department of Microbiology, Hospital Clinic - Universitat de Barcelona, Barcelona, Spain
Bassat Q:
ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique
ICREA, Catalan Institution for Research and Advanced Studies, Pg. Lluís Companys 23, 08010, Barcelona, Spain
Pediatric Infectious Diseases Unit, Pediatrics Department, Hospital Sant Joan de Déu (University of Barcelona), Barcelona, Spain
Menéndez C:
ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique
Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
Martínez MJ:
ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
Department of Microbiology, Hospital Clinic - Universitat de Barcelona, Barcelona, Spain
Ordi J:
ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain.
Department of Pathology, Hospital Clinic - Universitat de Barcelona, Barcelona, Spain.
Green Submitted, gold
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