Comparison of Stanford and DeBakey Classification Distributions Between Hospital-Diagnosed and Forensic Autopsy-Diagnosed Aortic Dissection Cases

Background: This study compared demographic characteristics and Stanford and DeBakey classification distributions between aortic dissection cases diagnosed in a tertiary hospital and those diagnosed at forensic autopsy. Methods: This retrospective comparative study included 58 cases diagnosed between 31 December 2019, and 1 January 2024. Hospital-diagnosed cases (n = 31) were identified from electronic medical records, whereas cases diagnosed at autopsy (n = 27) were retrieved from medico-legal autopsy reports. Demographic characteristics and classification distributions were compared. Results: Mean age was higher among hospital-diagnosed cases than among forensic autopsy-diagnosed cases (52.84 ± 17.59 vs. 43.93 ± 17.26 years; mean difference: 8.91 years; 95% CI: −0.27 to 18.10; p = 0.057). Stanford type A was more frequent among forensic autopsy-diagnosed cases (92.6% vs. 67.7%), with an absolute difference of 24.9 percentage points (95% CI: 3.8 to 43.2; Fisher’s exact p = 0.025). The overall DeBakey distribution also differed between the groups (Fisher–Freeman–Halton exact p = 0.044), with type III being 24.9 percentage points less frequent among forensic autopsy-diagnosed cases (95% CI: 3.8 to 43.2). Sex was not significantly associated with either classification. Conclusions: Stanford type A and DeBakey types I–II predominated among cases diagnosed at autopsy. These findings demonstrate classification differences according to diagnostic setting and emphasize the contribution of forensic autopsy to identifying fatal aortic dissections.