Autopsies performed at Universitas Academic Hospital, South Africa, 1990-2010, and perceptions and opinions of health professionals on the importance of autopsies in modern medicine

Background: Research has shown that the number of non-medicolegal (non-forensic) autopsies performed has declined worldwide in recent years. The aim of this study was to confirm a perceived decrease in the number of autopsies requested at the Universitas Academic Hospital Complex in Bloemfontein, and to evaluate clinicians' opinions on the possible reasons for this decline. Methods: All medical autopsies performed in four-year intervals between 1990 and 2010 were included in the study. Questionnaires were distributed to registrars and consultants in the Departments of Internal Medicine and Surgery. Results: The number of autopsies requested decreased from 308 in 1990 to only 60 in 2010, while the proportion of foetuses sent for autopsy increased from 2.3% of all autopsy requests in 1990 to 55.0% in 2010. Diseases of the respiratory system were the main cause of death in 1990, 1994 and 1998, while congenital conditions were the main finding in 2002, 2006 and 2010. The four most common reasons cited for the decline in the number of requests were difficulty in obtaining consent from relatives of the deceased, administrative problems when making requests for autopsies, the fact that medical autopsies are currently not performed on HIV-positive patients and the delay in obtaining autopsy reports. Conclusion: Despite the marked decline in autopsy requests, the vast majority of respondents were of the opinion that autopsies still play an important role in modern medicine and medical training. (C) SAJID