Steep Decline in Autopsy Rate Since 1970s

Aug. 4, 2011 -- The autopsy rate in the U.S. has declined dramatically since 1972, mainly because fewer autopsies are being done on people who die of disease, according to a new CDC report.

Overall, the percentage of deaths for which autopsies were performed declined from 19.3% in 1972 to 8.5% in 2007, a drop of more than 50%, according to the CDC’s National Center for Health Statistics.

In 1972, 79% of autopsies were done on people who died of disease, compared to 46% in 2007.

In 1972, 19% of autopsies were performed for deaths caused by assaults, accidents, gunshot wounds, poisonings, and other external reasons, according to the CDC report. By 2007, the percentage for those causes jumped significantly.

Autopsied Deaths

Autopsies are performed to confirm clinical findings, provide more complete information about the cause of a fatality, or uncover conditions not recognized before death.

Here are the 10 most common causes of autopsies in the U.S. as of 2007:

• Assault, 97.1% of deaths associated with assault were autopsied
• Legal intervention, 89.7% (This term was not defined in the study.)
• Undetermined events, 80.8%
• Accidental poisoning, 79%
• Accidental drowning or submersion, 74.3%
• Accidental discharge of firearms, 67.6%
• Accidental exposure to smoke, fire, and flames, 59.9%
• Pregnancy, childbirth, and deaths that occur within six weeks of childbirth, 54.5%
• Water, air, space, and other unspecified transport accidents, 50.9%

Other key findings of the report:

• Autopsy rates declined after ages 15-24, from 60% for young people in the 15-24 age group to 11% for people aged 55 to 64, and to less than 5% for people between 65 and 74.
• The autopsy rate increased slightly from 2003 to 2007, from 8.1% to 8.5%.

Autopsies either confirm or alter the original determination of cause of death and are more often performed when reasons are not obvious, such as for sudden infant death syndrome.

Following that reasoning, autopsy rates from 1972 through 2007 declined for deaths due to diseases from 16.9% to 4.3%. Autopsies for deaths caused by external reasons increased from 43.6% to 55.4%. Autopsy rates for deaths from ill-defined conditions rose from 26.4% to 29.1%.

9 in 10 Deaths Due to Disease or Illness

Even though 91% of deaths in the U.S. in 2007 were due to disease or medical condition, these cases were less likely to be autopsied than those due to external causes. Complications of pregnancy, childbirth, or that occurred in the first six weeks after childbirth was the only disease or medical condition among the 10 causes of death examined.

Autopsy rates decline with age because older people are more likely to die of disease than external causes, according to the researchers.

Researchers say the autopsy rate is influenced by factors such as hospital accreditation standards, state laws, and regulations about which deaths should be investigated, and also sudden and unexplained deaths of infants.

The study is published in National Center for Health Statistics Data Brief No. 67, August 2011.