15283-B-Blokker

22 Chapter 2 Each year the majority of the clinical autopsies were performed on men. The number of performed clinical autopsies decreased with a mean of 167 per year (95%CI: -176;-157) among men and 115 (95%CI: -120;-111) among women. If an in-hospital deceased patient was male, the odds of performing an autopsy were higher by a factor of 15.4% (95%CI: 1.144;1.164). The difference between men and women was also present with respect to autopsy rates, both clinical and forensic. Clinical autopsy rates declined with 0.7% per year among men and 0.6% per year among women (Fig 2-A). When divided into the three time periods the decline was similar between the sexes (Table 2). The forensic autopsy rates, on the other hand, showed no trend among women; only the 35-year trend among men showed a small but significant increase (0.001, 95%CI: 0.000-0.001). Age of the deceased At least a quarter of young adults died in a hospital, this fraction of in-hospital deceased increases up to the age group of 69 years olds (44.5%) and then declines to less than 10%. A total of 249,178 clinical autopsies were performed, most at the age of 76. Until that age there is a mean increase of 152 autopsies per year of age (95%CI: 134;169), after that age the number of autopsies decreases by 467 per year of age (95%CI: -508;- 426). Also, the autopsy rates were higher among patients who died at a younger age, with the highest peak at the age of 35. Until that age the autopsy rates increased with 0.2% per age year (95%CI: 0.001;0.003), and from the age 36 onwards the autopsy rates declined with 0.3% per age year (95%CI: -0.003;-0.003). All four age groups showed a decline in performed autopsies. In absolute numbers most clinical autopsies were performed in the age group of 60 to 79. Autopsy rates, on the other hand, were highest in the younger age groups for both clinical autopsies (Fig 2-B) and forensic autopsies. Compared to the age group of 80 years and older, the odds of a clinical autopsy being performed were 2.276 (95%CI: 2.218;2.335) among the 18-39 year age group, 1.986 (95%CI: 1.959;2.014) among the 40-59 year age group, and 1.598 (95%CI: 1.582;1.614) among the 60-79 year age group. Each calendar year the clinical autopsy rates declined within the range of 0.8% (youngest group) and 0.6% (oldest group), see Table 2. Hospital type A minority of the in-hospital deceased patients died in an academic hospital, but the autopsy rates were always higher in academic hospitals than in non-academic hospitals (Fig 2-C and Table 3). Over the years, academic autopsy rates declined more