CAUSES OF DEATH IN GERIATRIC-PATIENTS - A CROSS-CULTURAL-STUDY

Background. The elderly are living longer and causes of death are shif ting. At the same time, autopsy rate is at, or near, its lowest in his tory, compounded by an even lower interest in geriatric autopsies. Thu s, the prevalent cause of death in this age group remains poorly studi ed. Methods. In a retrospective study, the autopsy protocols of 440 70 -year-old or older patients from the Houston Veterans Affairs Hospital and 321 80-year-old or older patients from the II.Institute of Pathol ogy in Prague (Czech Republic) were reviewed in order to establish a c orrect cause of death. The autopsy diagnosis was correlated with the p rosectors' description of pathological findings in the protocol. In qu estionable cases or discrepancies, the patient's clinical chart and/or the histological autopsy slides were also reviewed. Results. The dist ribution of death by infections and cardiac disorders each accounted f or one-third of all deaths. Congestive heart failure prevailed in the over 80-year-olds, and myocardial infarcts prevailed in the younger pa tients. The number of deaths due to malignancy dropped from 25% in tho se 70-79 years old to about 10% in the elder patients. Central nervous system disorders were frequent as an underlying disease, but were not common as a cause of death. The findings were similar in both series, thus supporting their accuracy. Conclusion. Our findings bring into q uestion the accuracy of reported causes of death in the elderly With i ncreasing age, differences appear in the levels of mortality and morbi dity for various disease categories. This study underlines the need fo r more baseline data for older people which can be obtained only by mo re and well-performed autopsies.