Risk of pulmonary edema in mentally retarded persons

Pulmonary edema is an important medical risk for mentally retarded persons. To evaluate the predisposing conditions and their influence on clinical management, I analyzed 1,197 records with autopsy findings over a 40-year period in a state hospital. Of these, 220 subjects had severe pulmonary edema, and 433 had no pulmonary edema. There was more frequent occurrence in patients who were older, had higher IQs, and were ambulatory, as well as in those with epilepsy. Sudden death also predisposed to pulmonary edema. Atelectasis related prominently, but aspiration and pulmonary emphysema did not. Cardiovascular lesions were not a significant cause of pulmonary edema in this population. The underlying conditions must be considered in individualizing treatment.