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Age Trends in Autopsy Rates: Title and subTitle BreakStriking Decline in Late Life FREE

Judith C. Ahronheim, MD; Alissa S. Bernholc, MPH; William D. Clark, MA
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Reprint requests to New York University Medical Center, Old Bellevue C&D Bldg, Room 696, 550 First Ave, New York, NY 10016 (Dr Ahronheim).


JAMA. 1983;250(9):1182-1186. doi:10.1001/jama.1983.03340090038026
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Age-related autopsy rates were computed from 99,145 death certificates and disclosed a striking decline with advancing age, the peak (82.5%) occurring in the third decade of life, the nadir (2.4%) by age 90 years. The trend was the same for both sexes, although at all ages men were more likely to undergo autopsies than women. There was a significant decline in late life for medical examiner (ME) and non-ME cases. Rates varied according to immediate cause of death. The only causes of death in which there was no significant age-associated decline were homicide, suicide, and transport accidents, where autopsy is mandated by law. For other causes of death analyzed, rates declined significantly with age in both sexes, for ME as well as for non-ME cases. We conclude that low autopsy rates in late life are not artifactual but represent an overall phenomenon deserving closer scrutiny.

(JAMA 1983;250:1182-1186)

REFERENCES

Roberts WC:  The autopsy: Its decline and a suggestion for its revival . N Engl J Med 1978;; 299:332-338.
Facts About Older Americans , publication 80-20006. US Dept of Health and Human Services, 1979;.
Freeman JT:  The autopsy in geriatrics . J Am Geriatr Soc 1975;;23:1-10.
Collins JA:  The importance of autopsies in geriatric medicine . Geriatrics 1981;;36:33-39.
Hofman WI:  The pathologist and the geriatric autopsy . J Am Geriatr Soc 1975;;23:11-13.
International Classification of Disease: Manual of the International Statistical Classification of Diseases, Injuries, and Causes of Death . Geneva, World Health Organization, 1967;.
N.J.S.A. 52:17B-86.
Beadenkopf WG, Polan AK, Marks RU, et al:  Some demographic characteristics of an autopsied population . J Chronic Dis 1965;;18:333-351.
Cameron HM, McGoogan E, Clark J, et al:  Trends in hospital necrospy rates: Scotland 1961-1974 . Br Med J 1977;;1:1577-1580.
Koikkalainen K, Laustela E, Tala P:  Pathological study of arteriosclerosis in the coeliac and mesenteric circulation . Ann Chir Gynaecol Fenn 1968;;57:234-238.
Crump C:  The incidence of gallstones and gallbladder disease . Surg Gynecol Obstet 1931;; 53:447-455.
Torvik A, Hoivik B:  Gallstones in an autopsy series . Acta Chir Scand 1960;;120:168-174.
Howell TH:  Causes of death in nonagenarians . Surg Gynecol Obstet 1963;;5:139-143.
Britton M:  Diagnostic errors discovered at autopsy . Acta Med Scand 1974;;196:203-210.
Edlin GP:  Active tuberculosis unrecognized until autopsy . Lancet 1978;;1:650-652.
Bobrowitz ID:  Active tuberculosis undiagnosed until autopsy . Am J Med 1982;;72:650-658.
Rossman I, Rodstein M, Bornstein A:  Undiagnosed diseases in an aging population . Arch Intern Med 1974;;133:366-369.
Britton M:  Clinical diagnostics: Experience from 383 autopsied cases . Acta Med Scand 1974;;196:211-219.

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Roberts WC:  The autopsy: Its decline and a suggestion for its revival . N Engl J Med 1978;; 299:332-338.
Facts About Older Americans , publication 80-20006. US Dept of Health and Human Services, 1979;.
Freeman JT:  The autopsy in geriatrics . J Am Geriatr Soc 1975;;23:1-10.
Collins JA:  The importance of autopsies in geriatric medicine . Geriatrics 1981;;36:33-39.
Hofman WI:  The pathologist and the geriatric autopsy . J Am Geriatr Soc 1975;;23:11-13.
International Classification of Disease: Manual of the International Statistical Classification of Diseases, Injuries, and Causes of Death . Geneva, World Health Organization, 1967;.
N.J.S.A. 52:17B-86.
Beadenkopf WG, Polan AK, Marks RU, et al:  Some demographic characteristics of an autopsied population . J Chronic Dis 1965;;18:333-351.
Cameron HM, McGoogan E, Clark J, et al:  Trends in hospital necrospy rates: Scotland 1961-1974 . Br Med J 1977;;1:1577-1580.
Koikkalainen K, Laustela E, Tala P:  Pathological study of arteriosclerosis in the coeliac and mesenteric circulation . Ann Chir Gynaecol Fenn 1968;;57:234-238.
Crump C:  The incidence of gallstones and gallbladder disease . Surg Gynecol Obstet 1931;; 53:447-455.
Torvik A, Hoivik B:  Gallstones in an autopsy series . Acta Chir Scand 1960;;120:168-174.
Howell TH:  Causes of death in nonagenarians . Surg Gynecol Obstet 1963;;5:139-143.
Britton M:  Diagnostic errors discovered at autopsy . Acta Med Scand 1974;;196:203-210.
Edlin GP:  Active tuberculosis unrecognized until autopsy . Lancet 1978;;1:650-652.
Bobrowitz ID:  Active tuberculosis undiagnosed until autopsy . Am J Med 1982;;72:650-658.
Rossman I, Rodstein M, Bornstein A:  Undiagnosed diseases in an aging population . Arch Intern Med 1974;;133:366-369.
Britton M:  Clinical diagnostics: Experience from 383 autopsied cases . Acta Med Scand 1974;;196:211-219.
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