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Autopsy proven pulmonary embolism among the institutionalized elderly
Journal of the American Geriatrics Society
|October 1, 1986
Summary
Pulmonary embolism (PE) is often missed in elderly nursing home residents. Autopsy revealed a 12.8% incidence of PE, highlighting diagnostic challenges in this population.
Area of Science:
- Geriatrics
- Pathology
- Cardiology
Background:
- Pulmonary embolism (PE) presentation is highly variable, especially in the elderly.
- Common symptoms and risk factors for PE may be absent in older individuals.
Purpose of the Study:
- To determine the autopsy incidence of PE in a long-term care facility.
- To assess the rate of missed antemortem diagnoses of PE.
- To compare characteristics of patients with and without PE.
Main Methods:
- Retrospective chart and autopsy review of elderly patients over a six-year period.
- Analysis of 47 autopsies performed in a teaching nursing home.
Main Results:
- The incidence of pulmonary embolism was 12.8% in the studied nursing home population.
- Diagnosis of PE is challenging in the elderly due to atypical presentations and limited diagnostic pursuit.
- Few autopsies are performed in nursing homes, limiting data on PE in this setting.
Conclusions:
- Pulmonary embolism is a significant finding in elderly nursing home residents.
- The variability in presentation and diagnostic challenges contribute to underdiagnosis.
- Further research is needed to improve PE detection in long-term care facilities.