Pulmonary embolism and sudden–unexpected death: Prospective study on 2477 forensic autopsies performed at the Institute of Legal Medicine in Seville

Evaluation of meteorological and epidemiological characteristics of fatal pulmonary embolism

“…In the two tested groups, obesity was the main natural risk factor; in addition to this, in the violent death group, injury and immobilisation further increased the danger. We confirmed previous results that showed most of the PE arises as a result of embolism from deep vein thrombosis, most commonly from veins in the leg or pelvic region (Lucena et al 2009;Meral et al 2005;Dentali et al 2011). In 59.1 % of our cases, the source of embolism could be found in the lower extremities, mostly in deep iliofemoral veins, which form has a worse prognosis (Jenkins and Michael.…”

“…They can get into the lung and cause hemodynamic compromise. Therefore, PE represents a main public health problem worldwide with a great mortality, in about 25 % of victims, and it could be the first manifestation of sudden death (Stein et al 2005;Lucena et al 2009). The national statistical database suggests that in Hungary, the average mortality is about 130.000 per year (Statinfo, WHO), and the number of fatal PE cases were nearly 1000-1500 per year in the last decades.…”

Fatal pulmonary thromboembolism after prolonged physical immobilization in hospitalized psychiatric patients

“…Clinical manifestations of massive pulmonary thromboembolism (PTE) as the most serious DVT complication are regularly dramatic, but in some patients subtle or unspecific clinical symptoms can be seen. Then pulmonary embolism as the cause of sudden unexpected death appears as "unsuspected killer" 2,3 .…”

Early Stage Pulmonary Embolism Because of Stab Wound Injury Without Vascular Penetration

“…In >50% of cases of fatal pulmonary embolism, diagnosis is made during autopsy (5). The formation of a thrombus was first described by Rudolph Virchow in 1884 as hypercoagulability, stasis, and vascular wall damage; this information remains current (3,4). Strong factors underlying thromboembolism are fractures and spinal cord damage; moderate factors are central venous catheter, malignancy, oral contraceptive therapy, paralytic stroke, history of venous thromboemboli, and thrombophilia; and weak factors are >3 days of bedrest, lack of movements because of lengthy periods of sitting, and varicose veins (6).…”