Utilization of clinical autopsy services in a Nigerian teaching hospital

Objectives: The aim of this study was to ascertain the rate of uptake of clinical autopsy services in our hospital and also determine the associated factors. Autopsy is an important part of clinical practice. It serves as an audit and quality control for diagnosis and treatment of diseases. It also provides families with “informed grieving” by giving clearer understanding of the nature of illness and cause of death and may reveal inheritable or communicable diseases among other benefits. Despite these benefits, the rate of autopsy is low and declining globally. Material and Methods: A retrospective study of hospital autopsies performed from January 2013 to December 2017 was carried out. The mortuary and autopsy records of our hospital over the period were retrieved and reviewed. Deaths reported to the police, namely, coroner deaths and deaths before arriving at the hospital (brought in dead, BID) were excluded from the study. Results: A total of 1976 bodies was studied, 1078 males and 898 females (M:F = 1:1.2). Consent for autopsy was sought in 22 (1.1%) cases: 13 (0.66%) from pediatrics, 5 (0.25%) from internal medicine, and the rest from surgery and obstetrics and gynecology. Consent was granted and autopsy performed in 6 (0.3%) cases giving an average of 1.2 autopsies/year. Average hospital stay was 12.6 days and 36.3 days for those consenting to and those declining autopsy, respectively. Consenting persons belong to diverse socioeconomic strata. Conclusion: Autopsy rate is very low in our center. Attending clinicians and relatives of the deceased contribute to this trend. Vigorous education for all stakeholders about the benefits of hospital autopsy is recommended.