[Fatal pulmonary thromboembolism. A study of 178 cases]

A retrospective study was undertaken on 178 cases of fatal pulmonary thromboembolism, 86 males and 92 females, in whom major pulmonary emboli were found at autopsies, performed from 1971 to 1988. The 178 cases represent 6.9% from 2569 autopsies. In 43 cases (24.2%) the fatal pulmonary thromboembolism developed after surgery. The clinical diagnosis was performed in 59 cases (33.1%). The conditions at risk for fatal pulmonary thromboembolism were orthopedic surgery and radical surgery for malignancy among the surgical patients, and heart diseases and neoplasias among the medical patients. The death by fatal thromboembolism occurred in the 63.5% in the first six hours after onset of symptoms. The data suggest that recognition of those conditions which coexist with pulmonary thromboembolic disease can facilitate early diagnosis, and that when high risk is present antithrombotic prevention is of critical importance.