OBJECTIVETo summarize the major pathological findings, causes of deaths and reasons for misdiagnosis of 141 autopsy cases and thereby to improve the diagnosis level and reduce misdiagnosis.

METHODA retrospective analysis of pathological reports and clinical materials of 141 pediatric autopsy cases from June, 1986 to June, 2006 of our department was performed. Classification was based on (1) international classification of diseases of the World Health Organization; (2) age: cases 28 d-3 years old were defined as infants and young children group, -7 yeas olds were defined as preschool age group, -14 years olds were school age group; (3) when statistics was conducted, the first 3 items of the clinical diagnoses were counted. If one of them was consistent with the pathological diagnosis, it was regarded as basically in accordance with the pathology, if none of the first 3 was consistent with pathological diagnosis, the case was regarded as misdiagnosed.

RESULTS(1) The top three major pathological diagnosis and causes of death were: 1) Classified according to system: 41 cases had tumor (29.1%), 25 cases had respiratory diseases (17.7%), 18 cases had infectious diseases (12.7%); 2) Classified according to disease: 18 cases had malignant histiocytosis, 12 cases had sepsis, 11 cases had lobular pneumonia. (2) The causes of deaths changed gradually. The top cause of death was respiratory diseases during the former 10 years and was tumor during the latter 10 years; the materials showed that 95 cases were 28 d-3 years old (67.4%), and some rare diseases, such as mediastinal and lung chorionic epithelioma (choriocarcinoma), and pulmonary alveolar proteinosis were found. (3) In 90 cases the clinical diagnosis was basically in accordance with the pathological diagnosis (63.8%) and misdiagnosis was found in 51 cases (36.2%).

CONCLUSIONFor clinical diagnosis of critically ill patients, both common and rare diseases should be considered. Analysis of autopsy materials could confirm and/or correct clinical diagnosis and is helpful to summarize clinical diagnosis experience.