Autopsy histology data suggest cirrhosis is frequently under-reported on death certificates

Background: Cirrhosis may be asymptomatic yet contribute to ill health. Here, we studied how often cirrhosis is discovered first at an autopsy. We also examined how frequent this finding was not reported on formal death certificates. Methods: We used register-based data from all liver biopsies in Sweden performed after death. Cross-linkage to national registers was performed to examine how often such patients had accurate coding for cirrhosis on their death certificates. Findings: A total of 6187 patients with a liver biopsy performed after death, showing cirrhosis. Of these, 2523 (41%) did not have a diagnosis corresponding to cirrhosis on their final death certificate.

Automated summary

This study investigated the frequency of cirrhosis being discovered at autopsy and not being reported on death certificates. Using register-based data from liver biopsies in Sweden, it was found that out of 6187 patients with postmortem liver biopsies showing cirrhosis, 2523 (41%) did not have a corresponding diagnosis on their death certificates.