ORIGINAL ARTICLE

Fatal pulmonary embolism in hospitalised patients: a necropsy review

R Alikhan¹, F Peters², R Wilmott², A T Cohen²

¹ Department of Medicine, Royal United Hospital, Combe Park, Bath BA1 3NG, UK
² Academic Department of Surgery, Guy’s, King’s, and St Thomas’s School of Medicine, Bessemer Road, London SE5 9PJ, UK

Correspondence to:
Correspondence to:
Miss R Wilmott
Academic Department of Surgery, Guy’s, King’s, and St Thomas’s School of Medicine, Bessemer Road, London SE5 9PJ, UK; rosalind.wilmott{at}kcl.ac.uk

Aims: To carry out a retrospective review of all postmortem reports during the period 1991 to 2000 at King’s College Hospital, London, as an extension of a previous analysis performed for the period 1965 to 1990.

Methods: The number of deaths resulting from necropsy confirmed fatal pulmonary embolism in hospitalised patients was determined, and a limited analysis of the clinical characteristics of those patients who died was performed.

Results: During the 10 year period, 16 104 deaths occurred and 6833 (42.4%) necropsies were performed. The outcome measure, fatal pulmonary embolism, was recorded as cause of death in 265 cases (3.9% of all necropsies; 5.2% of adult cases). No deaths from pulmonary embolism occurred in patients under 18 years of age; 80.0% occurred in patients older than 60 years. Of the fatal emboli, 214 of 265 (80.8%) occurred in patients who had not undergone recent surgery. Of these patients, 110 (51.4%) had suffered an acute medical illness in the six weeks before death, most often an acute infectious episode (26 cases).

Conclusions: Thromboembolic events remain a relatively common cause of death in hospitalised patients and appear to occur more frequently in non-surgical than in surgical patients.

Abbreviations: MI, myocardial infarction; NCEPOD, National Confidential Enquiry into Perioperative Deaths; PE, pulmonary embolism; VTE, venous thromboembolic disease

Keywords: fatal pulmonary embolism; venous thromboembolism; death; hospitalised patient; medical illness; surgery

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Fatal pulmonary emboli in hospitalised patients: a necropsy review

Jonathan R. Salisbury, et al.

JCP Online, 13 Jan 2005 [Full text]