Autopsy Proven Pulmonary Embolism in Hospital Patients: Are We Detecting Enough Deep Vein Thrombosis?

To investigate the present status of pulmonary embolism as a cause of death in a general hospital patient population, a 5-year retrospective study of all autopsy reports and associated hospital records was undertaken. Pulmonary embolism was thought to be the cause of death in 239 of 2388 autopsies performed (10%): 15% of these patients were aged less than 60 years and 68% did not have cancer. Of these patients, 83% had deep-vein thrombosis (DVT) in the legs at autopsy, of whom only 19% had symptoms of DVT before death. Only 3% of patients who had DVT at autopsy had undergone an investigation for such before death. Twenty-four per cent of patients who died from pulmonary embolism had undergone surgery a mean of 6.9 days before. Screening tests for DVT should be applied widely in the hospital population.

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The Relationship between 125I-Fibrinogen Detected Thrombosis and Pulmonary Embolism

10.1055/s-0039-1689354 ◽

1975 ◽

Author(s):

G. V. Ruckley ◽

D. R. B. Jones ◽

I. M. C. Macintyre ◽

C. Vasilescu

Keyword(s):

Pulmonary Embolism ◽

Deep Vein Thrombosis ◽

Cause Of Death ◽

Screening Test ◽

Medical Patients ◽

Vein Thrombosis ◽

Lung Scan ◽

Fibrinogen Test ◽

Deep Vein ◽

The Relationship

A total of 846 surgical and medical patients have been screened by the 125I-fibrinogen test (I.F.T.). Deep vein thrombosis (D.V.T.) was detected in 174 (21%). In 49% of positives the condition was bilateral and in 33% the D.V.T. involved popliteal veins or above. In 14 patients pulmonary embolism was diagnosed by lung scan or at autopsy. In one massive embolism was the cause of death. All 14 had positive I.F.T’s. ; 10 bilateral and 10 with both calf and thigh vein thrombus. The relationship between positive I.F.T. and iliofemoral D.V.T. was studied with bilateral phlebography in 60 patients. In no case was isolated iliofemoral D.V.T found. We confirm the value of the I.F.T. as a screening test for potential embolism and observe that embolism from isolated iliofemoral D.V.T. is extremely rare.

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Faculty Opinions recommendation of Autopsy proven pulmonary embolism in hospital patients: are we detecting enough deep vein thrombosis?

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.714147867.789552926 ◽

2012 ◽

Author(s):

Victor Tapson

Keyword(s):

Pulmonary Embolism ◽

Deep Vein Thrombosis ◽

Vein Thrombosis ◽

Hospital Patients ◽

Deep Vein

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Preventing and treating deep vein thrombosis

Drug and Therapeutics Bulletin ◽

10.1136/dtb.30.3.9 ◽

1992 ◽

Vol 30 (3) ◽

pp. 9-12

Keyword(s):

Pulmonary Embolism ◽

Deep Vein Thrombosis ◽

Chronic Venous Insufficiency ◽

Venous Insufficiency ◽

Surgical Patients ◽

Fatal Pulmonary Embolism ◽

Venous Ulceration ◽

Vein Thrombosis ◽

Hospital Patients ◽

Deep Vein

Deep vein thrombosis (DVT) is a common event in hospital patients.1 The diagnosis is often missed, and its most serious sequel, fatal pulmonary embolism (PE) is still detected in 10% of hospital autopsies.2–3 DVT also commonly leads to chronic venous insufficiency and venous ulceration, treatment of which costs the NHS about £600 million a year.4 Deep vein thrombosis can be prevented in 60–75% of surgical patients,5 but many different prophylactic regimens are used, and some surgeons still use none.6 We discuss here who should receive prophylaxis, how it should be given, and review the treatment of established venous thrombosis.

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