Valor del diagnóstico de la tuberculosis pulmonar por autopsia en Cuba

the quality of medical care and the behaviour of the illness can be valued through the achievement of the pulmonary tuberculosis diagnosis by autopsy. objective: to determine the patients who died with pulmonary tuberculosis and because of it and to establish the agreement between the clinical and the pathological diagnoses in the analized period. method: a total of 77 341 necropsies taken from the cuban national autopsies register were analized taking as reference a period of ten years (1994-2003).the clinical records were examined in those cases in which active tuberculosis was found. results: the 0,2 % of the patients died with pulmonary tuberculosis and a 0.04 % died because of it. the average age was 69 years and 71 % of the persons were men. broncho-pneumonia was the most important cause of death. the diagnostic discrepancy between clinical and pathological diagnosis showed a 26 % as the direct cause of death and a 53 % as the basic cause of death. conclusion: an important percent of the deaths were by broncho-pneumonia and most of the patients died at an advanced age. it was confirmed a low frecuency of active pulmonary tuberculosis and there was diagnostic agreement in half of the patients. there was also a diagnostic disagreement in a third of the cases with direct cause of death. other investigations could define the factors of the post-mortem cases diagnosed with pulmonary tuberculosis which keep hidden the transmission of this disease.