Causes of death in over-85-year-old hospitalized patients: A retrospective study

Over the last decades, the autopsy rate has been declining steadily and autopsies are performed much less frequently in older people. The decline in the autopsy rate is associated with a reduced efficiency in measuring the accuracy of clinical diagnoses. The aim of this study was to analyze the autopsy rate, the causes of death and the clinical diagnostic accuracy in over-85-year-old patients. The study involved 1245 patients who died in the University Polyclinic "Umberto I" of Rome between January 1989 and December 1993. The low autopsy rate (15.1 %) and percentage of agreement between clinical and pathological diagnoses found are comparable with those found in other studies and may be due to factors connected to age. There is a tendency of the discrepancy rate to increase with age, probably because of the greater difficulty in making correct clinical diagnoses (lack of clear symptoms, presence of multiple pathologies). Our study has confirmed the importance of post-mortem examination in diagnosing and determining the true causes of death in elderly.