Autopsy rates have not been reported at the University Hospital of the West
Indies (UHWI) for more than three decades. Declining rates have been docum
ented worldwide, and so we sought to define autopsy rates over the past thr
ee decades at UHWI. We conducted a retrospective analysis of the numbers an
d types of autopsies performed on deaths occurring in the institution, and
calculated the relevant autopsy rates. The overall autopsy rate for the stu
dy period was 52.7%, with a statistically significant decline from 65.3% in
the first decade to 39.3% in the third. The non-coroner's autopsy rate sho
wed a concomitant decline from 57.5% to 31.5%, while the coroner's autopsy
rate remained stable with a slight increase from 28.1% to 29.1%. The factor
s that might have led to the decline of the autopsy are discussed.