Valuation of Underlying Diseases for Diagnosis Cause of Death in Thai Elderly: a Study in Unknown Forensic Autopsy Cases

Abstract

Cases of unnatural death in the elderly people tends to increase with the growing elderly population. For Thai social context, the corpse’s relatives tend to against autopsy because they believe that the cause of death be an existing disease, condition, “heart failure”, or old age. Consequently, the problems take place for case summary of a legal process and low quality of death certification. The objectives of this study were to assess (1) the causes of death in the elderly, (2) the accuracy of the cause of death using the underlying diseases, and (3) the appropriate age for the conclusion of the death from the old age. It was conducted as a retrospective cross-section study from the elderly people who died with initial unknown cause of death and were autopsied at Maharat Nakhon Ratchasima Hospital between 1 January 2016 and 31 December 2020. The data were analyzed with ANOVA, t-test, Fisher’s exact, multiple logistic regression, and predictive value methods. The study found that there were 266 corpses that fitted the study criteria, with an average age of 71.78 years. The most common causes of death were coronary artery disease, pneumonia, and abdominal aortic aneurysm rupture, respectively. The value of diagnosis for coronary artery disease as a cause of death by using underlying diseases or conditions was low. The diagnosis of old age as a cause of death required an autopsy to rule out other causes of death. Autopsy was an important process in surveillance of injury and crime as well. The process would also improve patient quality of care by exploring the cause of death and injuries connected with medical errors.