Article Text

Download PDFPDF
Fatal pulmonary embolism in hospitalised patients: a necropsy review
  1. R Alikhan1,
  2. F Peters2,
  3. R Wilmott2,
  4. A T Cohen2
  1. 1Department of Medicine, Royal United Hospital, Combe Park, Bath BA1 3NG, UK
  2. 2Academic Department of Surgery, Guy’s, King’s, and St Thomas’s School of Medicine, Bessemer Road, London SE5 9PJ, UK
  1. 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;


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.

  • MI, myocardial infarction
  • NCEPOD, National Confidential Enquiry into Perioperative Deaths
  • PE, pulmonary embolism
  • VTE, venous thromboembolic disease
  • fatal pulmonary embolism
  • venous thromboembolism
  • death
  • hospitalised patient
  • medical illness
  • surgery

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.