An Analysis of 60 Years of Autopsy Data from Zhejiang University in Hangzhou, China

CONTEXT: The autopsy rate gradually decreased during 1950–1999, and increased during the most recent decade (2000–2009). The diagnostic inaccuracy rate was continuously high during the 60 years. OBJECTIVE: To investigate disagreement between the pathological and clinical diagnosis during 60 years (1950–2009). DATA SOURCES: A 60-year retrospective study was carried out on the 4140 autopsy cases performed in Zhejiang University School of Medicine. RESULTS: The highest number of cases was 1037 during 1960–1969, while the lowest was 102 during 1990–1999. During the 1999–2009 period, 978 cases were completed, which ranked second within the 60 years. The total clinical misdiagnosis rate was 46.38%, while the highest was 73.82% in 2000–2009. During the 60 years, the diseases associated with highest diagnostic inaccuracy rates were circulatory diseases (76.97%), cancer (60.99%), and brain diseases (54.48%). The invasive fungal infection rate was 1.84% of the 4140 cases, and the diagnostic inaccuracy rate for this condition reached as high as 86.10%. In the autopsied disease spectrum over the 60 years, the most common diseases were respiratory (1349, 32.58%), circulatory (495, 11.96%), and brain diseases (424, 10.24%). CONCLUSION: Although the number of autopsies decreased from 1950 to 1999, it increased from 2000 to 2009, while the discordance rate between clinical and autopsy diagnosis remained high throughout.