15283-B-Blokker

40 Chapter 3 RESULTS Overall In 958 of the 1000 cases the information gained from the collected questionnaires and the EPR was eligible for our analyses. In 873 of the 958 (91.1%) eligible cases the clinicians had filled in the questionnaire, in the 85 (8.9%) remaining cases the information on the consent process could be retrieved from the EPR. In 167 cases (17.4%) of these the clinician reported not to have requested consent for autopsy, and in 147 (18.6%) of the remaining 791 cases the next-of-kin consented to an autopsy including at least thorax and abdomen (see Fig 1), resulting in an overall autopsy rate of 14.7%. Autopsy percentages and distribution of cases Among the 1000 cases, the highest overall autopsy rates measured per variable were 16.1% among women, 20.1% among deceased in the age group of 60-69 years old, 18.8% among deceased who had never been married, 16.7% among Europeans, 20.0% among Catholics, 15.2% among the sudden and/or unexpected deaths, and 40.0% among organ donors. Considering only the 958 cases with information about the consent process, the measured autopsy rates were slightly different. Table 1 shows these cases and their distribution across the outcome measures concerning autopsy request and consent, per patient characteristic and clinical aspect. The measured autopsy rates derived from this table are still highest among all the subgroups mentioned above, apart from the subgroup of ages. The autopsy rates in the subgroup of 30-39 years of age are the highest with 22.2%. The Chi Square tests showed that the outcomes of the consent process were unequally distributed over some of the variables. The distribution of all 1000 cases per ward is shown in Fig 2. According to the Chi Square test, the outcome measures (autopsy not requested, autopsy not performed, autopsy performed) within the 958 cases were unequally distributed across the different wards (P<0.001, df=18). Motives for decisions on autopsy consent The main motive of clinicians to not request autopsy was a ‘ supposed known cause of death ’ (Fig 3-A). This motive was mentioned in 86 of the 167 (51.5%) cases. Their second motive, ‘ a long illness after which an autopsy would be too much to request’ was mentioned in only 16 (9.6%) cases, in nine (5.4%) it was combined with the first motive. In 15 (9.0%) cases clinicians did not request an autopsy because of ‘ their expectation not to get consent from next-of-kin ’.