ORIGINAL ARTICLE

The quality and value of sudden infant death necropsy reporting in Ireland

K M Sheehan¹, M McDonnell³, E M Doyle¹, T Matthews² and D M Devaney¹

¹ Department of Pathology, The Children’s University Hospital, Temple Street, Dublin 1, Ireland
² Department of Paediatrics, The Children’s University Hospital
³ The National Sudden Infant Death Register of the Irish Sudden Infant Death Association, the Children’s University Hospital

Correspondence to:
Correspondence to:
Dr D Devaney, Department of Pathology, The Children’s University Hospital, Temple Street, Dublin 1, Ireland;
deirdre.devaney{at}tsch.ie

Background: Infant necropsies are important for identifying cause of death. Recently issued guidelines have recommended investigations to be performed following sudden unexpected death in infants.

Aims: To evaluate the quality and value of infant postmortem reporting.

Methods: Postmortem reports from 1994–1996 and 1998–2000 in Ireland were evaluated using the National Sudden Infant Death Register. Scoring was by a modification of the Rushton system based on the extent of the postmortem data. The finding of additional pathological information was also assessed.

Results: Of the 274 cases registered during the selection period, reports were available for 245. Overall quality of necropsy reporting was below the minimum accepted standard in 55.5%; 47% of the necropsies were performed in regional paediatric pathology centres. The quality of necropsies performed in regional centres was significantly higher than those performed elsewhere. Although 86% of the cases were defined as sudden infant death syndrome (SIDS; no cause of death found), the finding of additional pathological information was significantly related to the extent of the necropsy. There was a significant improvement in the quality of necropsies after the postmortem guidelines were issued.

Conclusions: The overall quality of sudden unexpected infant death necropsies in Ireland is less than adequate. A minimum accepted standard of necropsy is required before a diagnosis of SIDS can be made. Although standards have improved recently, this study highlights the need to adhere to published guidelines and the importance of auditing the effect of introducing practice guidelines on clinical practice to complete the audit loop.

Keywords: sudden infant death; necropsy; quality; value

Abbreviations: CSO, Central Statistics Office; MAS, minimum accepted score; NSIDR, National Sudden Infant Death Register; SIDS, sudden infant death syndrome; SUDS, sudden and unexpected infant deaths

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

• Sheehan, K M, McGarvey, C, Devaney, D M, Matthews, T (2005). How reliable are SIDS rates?. Arch. Dis. Child. 90: 1082-1083 [Abstract] [Full Text]  

eLetters:

Read all eLetters

Importance of mitochondrial function in SIDS

Richard G Fiddian-Green

JCP Online, 24 Nov 2003 [Full text]