[Pulmonary embolism. Clinical suspicion and anatomopathological correlation]

Area of Science:

• Pathology
• Cardiovascular Medicine
• Clinical Diagnostics

Background:

• Discrepancies between clinical suspicion and pathological findings for pulmonary embolism (PE) are common.
• Pulmonary embolism is a significant cause of mortality, yet often underdiagnosed clinically.

Purpose of the Study:

• To determine the prevalence of PE in a necropsy series.
• To analyze the relationship between clinical suspicion and autopsy-confirmed PE.
• To assess the role of PE as a cause of death in an acute care hospital setting.

Main Methods:

• Retrospective observational study of 350 autopsies performed between 1998 and 2017.
• Analysis of demographic data, clinical diagnoses, autopsy findings, and cause of death.
• Comparison of clinical suspicion with autopsy-diagnosed PE and its contribution to mortality.

Main Results:

• Pulmonary embolism was diagnosed in 36.3% of autopsies.
• Only 8% of cases had PE as the clinical diagnosis, and only 15.7% of confirmed PE cases had prior clinical suspicion.
• PE was a contributor or cause of death in 30.9% of cases, affecting various vessel sizes.

Conclusions:

• Pulmonary embolism is a highly prevalent finding in autopsies and an important cause of death.
• The low concordance between clinical suspicion and autopsy diagnosis underscores the need for enhanced clinical awareness and early diagnosis of PE.
• Improved clinical suspicion is crucial for timely diagnosis and treatment of pulmonary embolism.