15283-B-Blokker

39 Autopsy considerations in the consent process 3 patient died, the way of dying (an unexpected or sudden death/ death after being ill for a longer period of time, a so called “long illness”), and who decided on consent for autopsy (partner/relatives/non-relatives). Outcome measures were defined as: consent for autopsy requested (yes/no); consent for autopsy given (yes/no); the motivation for either decision; autopsy performed (yes/ no). An autopsy had at least to include examination of thorax and abdomen. Multiple-choice questions, based on the literature, 30,38,40,41,81 were used to trace the considerations behind the decisions of clinicians and next-of-kin. Per multiple-choice question one or more motives could be given. A final, open question for “other motives” gave the option to enter any motives not yet addressed. If a case record in the EPR mentioned “ autopsy not permitted ”, this was interpreted as autopsy consent having been requested by clinicians and not given by next-of-kin. In such cases the motives of next-of-kin remained unknown. If the case record said “ no autopsy ”, or if autopsy was not mentioned at all, it remained unknown whether or not consent was requested, and whether next-of-kin had been given the chance to consider autopsy. Data analysis and presentation All information obtained from the questionnaires and the EPR was entered in an SPSS database. Missing variables within a case were scored as ‘unknown’, and included in the analyses. Autopsy rates were calculated for all cases combined, and for specific subgroups. Per clinical ward the total number of deceased, the number of autopsies requested, and the number of given consents were presented graphically. Cases were not eligible for further analyses if all outcome variables on decisions and considerations concerning autopsy consent were missing. Per subgroup in the consent process the percentage of given motives was plotted. Patient characteristics and clinical aspect outcomes were cross-tabulated. To this end they were sorted into three groups: the numbers of autopsies not requested, the number of autopsies requested but not performed (including two restricted autopsies, and one case in which family abroad could not finalize the consent by signing the consent form), and the number of autopsies requested and performed. For each variable the distribution of cases within these three groups was analysed by Chi Square tests. If necessary subgroups were combined to meet the criteria for a valid Chi Square test: 80% of the cells in the table should have expected frequencies greater than five, and all cells should have expected frequencies greater than one.