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Med J Aust. 1994 Feb 7;160(3):127-8.

Autopsy evidence of pulmonary thromboembolism.

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  • Department of Anatomical Pathology, St Vincent's Hospital, Fitzroy, Vic.

Abstract

OBJECTIVE:

To determine the prevalence of pulmonary thromboembolism (PE) and underlying risk factors at autopsy, compared with clinical diagnosis.

DESIGN:

Retrospective review of autopsy records, death certificates and medical histories.

PATIENTS AND SETTING:

All 132 patients who underwent autopsy at St Vincent's Hospital, Melbourne, in 1992.

RESULTS:

Sixteen cases (12% of autopsies) of PE were found at autopsy. In only two had PE been recorded on the death certificate; in one other, diagnosis had been made before death. Associated pulmonary infarction and/or haemorrhage was found in only six patients with PE. All 16 had at least one underlying risk factor: advanced age, cancer, heart disease, or recent pelvic or abdominal surgery. In four patients with missed PE, clinical records showed episodes consistent with PE. There were four false-positive diagnoses.

CONCLUSIONS:

Significant undiagnosed pulmonary embolism is not uncommon at autopsy. Many episodes are clinically silent, but the diagnosis should be suspected in at-risk patients with unexplained episodes of dyspnoea and tachycardia.

PMID:
8295579
[PubMed - indexed for MEDLINE]
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