A 20-Year Review of Hospital Autopsies in a Nigerian Tertiary Hospital

Abstract

Background: The hospital autopsy often serves as an audit of clinical practice. It also provides useful epidemiological data about the causes of mortality in the society, though requests for autopsy might not be made for conditions where the cause and course of disease is well understood. The changing trends of disease incidence and outcomes can also be captured by autopsy studies and it serves to realign public health initiatives in the prevention and treatment of common illnesses. The aim of this study was to assess the patterns of mortality that were confirmed by autopsy in our institution over a 20- year period. Design: Data which included the age, sex and cause of death were retrieved from the departmental archives from January 1996 to December 2015. The causes of death were classified into categories which included but were not limited to infectious, cardiovascular-related deaths, trauma, malignancy, pregnancy-related, perinatal etc. These were analyzed and represented in tables, charts and graphs. Results: The number of deaths that met the inclusion criteria were 3115. Of these, the majority (31.9%) were seen in the 20-40year age group. Most paediatric deaths (0-20years) occurred in the perinatal period (39.7.8%). Outside the neonatal age group, infections were the commonest cause of death in children (53.8%). The commonest causes of death in adults were related to diseases of the cardiovascular system (25.5%), though trauma was the commonest cause of death in males aged 20-40yrs, and pregnancy-related deaths were the commonest causes of death in females of that same age group. Death due to malignancies and cardiovascular related deaths were each seen most commonly in the 40-60yrs age bracket. Death associated with congenital abnormalities occurred predominantly in infants. Over the years, there was a steady increase in the rate of deaths arising from cardiovascular diseases, which eventually replaced trauma as the commonest cause of adult deaths seen at autopsy. Conclusions: The increased prevalence of cardiovascular disease-related deaths shows the adoption of western lifestyle by inhabitants of Lagos.