Discrepancies between clinical and autopsy diagnosis of cause of death among psychiatric patients who died due to natural causes.  A retrospective autopsy study

Dragan Mitrović; Ivana Savić; Radmila Janković

doi:10.2298/VSP170304132M

Dragan Mitrović Institut za patologiju, Medicinski fakultet, Univerzitet u Beogradu, Srbija
Ivana Savić Institute of Pathology, University of Belgrade – School of Medicine, Belgrade, Serbia
Radmila Janković Institute of Pathology, University of Belgrade – School of Medicine, Belgrade, Serbia

DOI: https://doi.org/10.2298/VSP170304132M

Ključne reči: autopsija, smrt, uzrok, smrt, iznenadna, dijagnoza, bolnice, opšte, bolnice, psihijatrijske, psihički poremećaji, bolesnici

Sažetak

Apstrakt

Uvod/Cilj. Obdukcijske studije se retko bave ispitivanjem prirodnih uzroka smrti kod psihijatrijskih bolesnika. Cilj istraživanja bio je ispitivanje uzroka smrti bolesnika sa različitim psihijatrijskim oboljenjima, u slučajevima gde je tražena i urađena patoanatomska (klinička) obdukcija. Metode. U istraživanje je bilo uključeno 118 bolesnika (65% muškaraca, 35% žena, prosečne starosti 58,2 ± 13,6 godina) sa dijagnozom psihijatrijske bolesti kojima je rađena patoanatomska (klinička) obdukcija. Poređena je distribucija uzroka prirodne smrti psihijatrijskih bolesnika sa drugim bolesnicima (koji reprezentuju opštu populaciju) umrlim zbog prirodnih uzroka smrti, a ispitivane su i razlike između kliničkih i autopsijskih dijagnoza uzroka smrti kod psihijatrijskih bolesnika. Rezultati. Psihijatrijski bolesnici umirali su ranije u odnosu na opštu populaciju (58 vs. 69 godina), najčešće zbog respiratornih (46%) i kardiovaskularnih bolesti (37%). Najčešće dijagnoze kod psihijatrijskih bolesnika bile su organske psihoze i demencije (F00-F09) i shizofrenija i shizoafektivni poremećaji (F20-F29). Većina njih (55%) umirala je u opštim bolnicama, a 45% u psihijatrijskim bolnicama zbog somatskih oboljenja. Ustanovljena je značajna razlika u distribuciji uzroka smrti u odnosu na kontrolnu grupu u kojoj su dominirale kardiovaskularne bolesti. Kod 64% psihijatrijskih bolesnika postojale su značajne razlike u kliničkoj dijagnozi uzroka smrti u odnosu na konačan obdukcioni nalaz. Zaključak. Dijagnostika somatskih bolesti kod psihijatrijskih bolesnika je nedovoljna, pogotovo u psihijatrijskim bolnicama. Ovo dovodi do značajnog neslaganja između kliničkih i autopsijskih dijagnoza uzroka smrti u ovoj populaciji. Potrebno je posvetiti dodatnu pažnju ispitivanju i lečenju somatskih bolesti kod ovih bolesnika da bi se poboljšala njihova zdravstvena zaštita.

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Neslaganje između kliničkih i autopsijskih dijagnoza uzroka smrti među psihijatrijskim bolesnicima umrlim zbog prirodnih uzroka

Sažetak

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