Some epidemiologic considerations of thromboembolism

Coon, William W.; Coller, Frederick A.

doi:10.1097/00006534-196006000-00029

Cited by 27 publications

(37 citation statements)

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“…Routine autopsy itselfwill underestimate the true incidence of PE'614 and although the rate of detection can be increased by fixation of the lung by inflation with formalin and careful sectioning14'15, routine techniques in this hospital found fatal pulmonary embolism in 10% of autopsies. Other studies have found the incidence to be between 9% and 21%1, 6,11,14,17 This study has demonstrated that PE is still a major cause of death in hospital patients despite advances in diagnosis and treatment of this condition. A 10% incidence of hospital patients dying of PE is unacceptably high, since PE is preventable and treatable.…”

Section: Discussionmentioning

confidence: 69%

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

1989

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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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Section: Discussionmentioning

confidence: 69%

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

1989

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“…4 In well over a third of patients with acute myocardial infurction who are not receiving anticoagulants, evidence ofDVT can be seen on specialized radionuclide studies. 5 …”

Section: Risk Andctorsmentioning

confidence: 99%

Pulmonary embolism

Kutty

1990

Postgraduate Medicine

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“…The awareness of risk factors, symptoms and signs should allow to raise early suspicion of pulmonary embo lism (PE); however, in most patients the disease remains unknown since it is not suspected or misdiagnosed [1][2][3]. This is due to the absence of specific clinical signs, mostly in patients with previous pulmonary pathologies [4][5][6].…”

Section: Introductionmentioning

confidence: 99%

A Way to Select on Clinical Grounds Patients with High Risk for Pulmonary Embolism: A Retrospective Analysis in a Nested Case-Control Study

et al. 1995

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We studied 196 patients with suspicion of pulmonary embolism (PE), subsequently confirmed in 98 by positive pulmonary angiography and excluded in 98 by normal or near-normal perfusion lung scan. Patients had a clinical questionnaire for history, and, soon after, a radiograph, blood gas analysis, and an ECG. Clinical and instrumental signs were matched in patients with confirmed and unconfirmed PE to find those more frequent in embolic patients and, thus, more characteristic of PE. The following were: previous PE, immobilization and thrombophlebitis (p < 0.05); dyspnea and cough (p < 0.05); enlarged descending pulmonary artery (DPA), enlarged right heart, pulmonary infarction, Westermark sign (p < 0.001), and elevated diaphragm (p < 0.05); hypoxemia. No ECG sign was more frequent in PE. Thereafter, all variables were processed separately with a logistic multiple regression analysis and those significantly associated to PE were tested in a final logistic model that was able to predict the actual result of angiography or scintigraphy; accordingly, previous PE, immobilization, thrombophlebitis, enlarged DP A, pulmonary infarction, Westermark sign, hypoxemia were significantly associated with a high risk of PE (from 2.8 to 15 times greater than in patients without these signs). Therefore, we may conclude that clinical assessment and noninvasive tests may help to detect patients at higher risk for PE where heparin coverage should be started while waiting for conclusive diagnostic procedures.

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Some epidemiologic considerations of thromboembolism

Cited by 27 publications

References 0 publications

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

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

Pulmonary embolism

A Way to Select on Clinical Grounds Patients with High Risk for Pulmonary Embolism: A Retrospective Analysis in a Nested Case-Control Study

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