BACKGROUND: The diagnosis of death certificate is very used in statistics of public health. However, its completion is only based on the macroscopic diagnosis of autopsy. When comparing macroscopia with the autopsy's final award, we realize that microscopia is decisive and modifies death certificate's award many times. OBJECTIVES: Prospectively evaluate the differences between gross and microscopic disgnosis of death cause and the limitations of death certificate as an epidemiologic tool. METHOD: 100 autopsies were performed and studied at the Departamento de Pathologia da Faculdade de Medicina de São José do Rio Preto, between July, 2000 and May, 2001. A total of 65 men and 35 women were studied and they were 44,17 years old on average. The basic and the immediate causes of obit were taken from death certificate and compared with the diagnosis on the final award of each autopsy. RESULTS: Based on the total of 100 autopsies, 16 had a discordant diagnosis on the immediate cause and 22 discordant cases on the basic cause of death. Discordance were mainly on lungs, kidneys, liver and heart. CONCLUSIONS: Although death certificate is very used, it shows limitations as an epidemiologic tool. As a consequence, the microscopic study is conclusive especially when it is related to the mentioned organs, in which macroscopia shows a diagnostics limitation.
Death certificate; Macroscopia; Microscopia; Autops
