The value of postmortem computed tomography as an alternative for autopsy in trauma victims: a systematic review

The aim of this study was to assess the role of postmortem computed tomography (PMCT) as an alternative for autopsy in determining the cause of death and the identification of specific injuries in trauma victims. A systematic review was performed by searching the EMBASE and MEDLINE databases. Articl...

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Bibliographic Details
Published in:European radiology 2009-10, Vol.19 (10), p.2333-2341
Main Authors: Scholing, M., Saltzherr, T. P., Fung Kon Jin, P. H. P., Ponsen, K. J., Reitsma, J. B., Lameris, J. S., Goslings, J. C.
Format: Article
Language:English
Subjects:
Autopsy - methods
Autopsy - statistics & numerical data
Cause of Death
Clinical Trials as Topic
Diagnostic Radiology
Forensic Medicine
Humans
Imaging
Internal Medicine
Interventional Radiology
Medicine
Medicine & Public Health
Neuroradiology
Radiology
Tomography, X-Ray Computed - statistics & numerical data
Ultrasound
Wounds and Injuries - diagnosis
Wounds and Injuries - mortality
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Summary:The aim of this study was to assess the role of postmortem computed tomography (PMCT) as an alternative for autopsy in determining the cause of death and the identification of specific injuries in trauma victims. A systematic review was performed by searching the EMBASE and MEDLINE databases. Articles were eligible if they reported both PMCT as well as autopsy findings and included more than one trauma victim. Two reviewers independently assessed the eligibility and quality of the articles. The outcomes were described in terms of the percentage agreement on causes of death and amount of injuries detected. The data extraction and analysis were performed together. Fifteen studies were included describing 244 victims. The median sample size was 13 (range 5–52). The percentage agreement on the cause of death between PMCT and autopsy varied between 46 and 100%. The overall amount of injuries detected on CT ranged from 53 to 100% compared with autopsy. Several studies suggested that PMCT was capable of identifying injuries not detected during normal autopsy. This systematic review provides inconsistent evidence as to whether PMCT is a reliable alternative for autopsy in trauma victims. PMCT has promising features in postmortem examination suggesting PMCT is a good alternative for a refused autopsy or a good adjunct to autopsy because it detects extra injuries overseen during autopsies. To examine the value of PMCT in trauma victims there is a need for well-designed and larger prospective studies.
ISSN:0938-7994
1432-1084
DOI:10.1007/s00330-009-1440-4