Fatal pulmonary embolism in hospitalized patients: a large autopsy-based matched case-control study

Authors

  • Solange Aparecida Petilo Carvalho Bricola Universidade de São Paulo; Faculdade de Medicina da; Department of Medicine
  • Edison Ferreira Paiva Universidade de São Paulo; Faculdade de Medicina da; Department of Medicine
  • Arnaldo Lichtenstein Universidade de São Paulo; Faculdade de Medicina da; Department of Medicine
  • Reinaldo José Gianini Universidade de São Paulo; Faculdade de Medicina da; Preventive Medicine; Department of Medicine
  • Jurandir Godoy Duarte Universidade de São Paulo; Faculdade de Medicina da; Department of Medicine
  • Samuel Katsuyuki Shinjo Universidade de São Paulo; Faculdade de Medicina da; Rheumatology
  • Jose Eluf-Neto Universidade de São Paulo; Faculdade de Medicina da; Preventive Medicine; Department of Medicine
  • Milton Arruda Martins Universidade de São Paulo; Faculdade de Medicina da; Department of Medicine

DOI:

https://doi.org/10.1590/clin.v68i5.76846

Abstract

OBJECTIVE: Pulmonary embolism is an underdiagnosed major cause of death for hospitalized patients. The objective of this study was to identify the conditions associated with fatal pulmonary embolism in this population. METHODS: A total of 13,074 autopsy records were evaluated in a case-control study. Patients were matched by age, sex, and year of death, and factors potentially associated with fatal pulmonary embolism were analyzed using univariate and multivariate conditional logistic regression. RESULTS: Pulmonary embolism was considered fatal in 328 (2.5%) patients. In the multivariate analysis, conditions that were more common in patients who died of pulmonary embolism were atherosclerosis, congestive heart failure, and neurological surgery. Some conditions were negatively associated with fatal pulmonary embolism, including hemorrhagic stroke, aortic aneurism, cirrhosis, acquired immune deficiency syndrome, and pneumonia. In the control group, patients with hemorrhagic stroke and aortic aneurism had short hospital stays (8.5 and 8.8 days, respectively), and the hemorrhage itself was the main cause of death in most of them (90.6% and 68.4%, respectively), which may have prevented the development of pulmonary embolism. Cirrhotic patients in the control group also had short hospital stays (7 days), and 50% died from bleeding complications. CONCLUSIONS: In this large autopsy study, atherosclerosis, congestive heart failure, and neurological surgery were diagnoses associated with fatal pulmonary embolism.

Downloads

Download data is not yet available.

Downloads

Published

2013-05-01

Issue

Section

Clinical Sciences

How to Cite

Carvalho Bricola, S. A. P., Paiva, E. F., Lichtenstein, A., Gianini, R. J., Duarte, J. G., Shinjo, S. K., Eluf-Neto, J., & Arruda Martins, M. (2013). Fatal pulmonary embolism in hospitalized patients: a large autopsy-based matched case-control study. Clinics, 68(5), 679-685. https://doi.org/10.1590/clin.v68i5.76846