The value of post mortems in cardiac surgery: learning from the dead

BACKGROUND: Little information is available regarding the role of post-mortem in cardiac surgery. The cause of death by clinical presumption can be misleading. The aim is evaluate the role of post-mortem following cardiac surgery by comparing clinically attributed causes of death versus post-mortem findings. METHODS: A total of 10,099 cardiac operations were performed over a seven-year period in a single institution in the United Kingdom. There were 363 (3.6 ) deaths. The mean age at death was 71 with 66.7 male. Of these, 348 (95.9 ) patients underwent a post-mortem examination. RESULTS: There was a significant disparity between presumed and actual causes of death in 78 (22.4 ) patients. The commonest unrecognised cause of death was cardiac causes (21 patients, 6.0 ). The most overestimated cause of death was multi-organ failure, which was incorrectly diagnosed as the cause of death in 28 patients (8.0 ). CONCLUSIONS: Post-mortem can determine unsuspected diagnoses in a significant proportion of patients undergoing cardiac surgery. It plays an important role in cardiac surgery and remains essential for quality assessment in perioperative treatment.