Postmortem Interval and Diagnostic Performance of the Autopsy Methods. Issue 1 (December 2018)

• Record Type: Journal Article
• Authors: Hurtado, Juan; Quintó, Llorenç; Castillo, Paola; Carrilho, Carla; Fernandes, Fabiola; Jordao, Dercio; Lovane, Lucilia; Navarro, Mireia; Casas, Isaac; Bene, Rosa; Nhampossa, Tacilta; Santos Ritchie, Paula; Bandeira, Sónia; Sambo, Calvino; Chicamba, Valeria; Mocumbi, Sibone; Jaze, Zara; Mabota, Flora; Ismail, Mamudo; Lorenzoni, Cesaltina; Guisseve, Assucena; Rakislova, Natalia; Marimon, Lorena; Castrejon, Natalia; Sanz, Ariadna; Cossa, Anelsio; Mandomando, Inacio; Munguambe, Khátia; Maixenchs, Maria; Muñoz-Almagro, Carmen; Macete, Eusebio; Alonso, Pedro; Vila, Jordi; Bassat, Quique; Menéndez, Clara; Martínez, Miguel; Ordi, Jaume;
• Is Part Of: Scientific reports. Volume 8:Issue 1(2018)
• Page Start: 1
• Page End: 10
• Publication Date: 2018-12
• Subjects: Natural history -- Research -- Periodicals; Biology -- Research -- Periodicals; Physical sciences -- Research -- Periodicals; Earth sciences -- Research -- Periodicals; Environmental sciences -- Research -- Periodicals; 502.85
• DOI: 10.1038/s41598-018-34436-1
• Languages: English
• ISSNs: 2045-2322

Abstract

Abstract 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 theEnterobacteriaceae family andPseudomonas 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 ofEnterobacteriaceae andPseudomonas spp . as etiological agents of infections leading to death may be overestimated.