Skip to main content
Top
Published in: Forensic Science, Medicine and Pathology 2/2018

01-06-2018 | Commentary

The autopsy and diagnosis of pulmonary thrombo-embolism

Author: Milton J. Micallef

Published in: Forensic Science, Medicine and Pathology | Issue 2/2018

Login to get access

Abstract

Pulmonary thrombo-embolism (PTE) is a common cause of death but is frequently undetected by clinicians in spite of advanced diagnostic techniques. The autopsy has traditionally been used to identify the rate of PTE in hospital patients, but the decline in autopsy rates – especially in hospitals – has led to insufficient recent data from which to comment with confidence on the true rate of death from latent PTE. Widespread prophylactic anticoagulation regimens against venous thrombosis may induce complacency amongst clinicians. PTE continues to occur and to kill, and autopsies should be performed more frequently to better estimate the true prevalence of this condition.
Literature
1.
go back to reference Modan B, Sharon E, Jelin N. Factors contributing to the incorrect diagnosis of pulmonary embolic disease. Chest. 1972;62:388–93.CrossRefPubMed Modan B, Sharon E, Jelin N. Factors contributing to the incorrect diagnosis of pulmonary embolic disease. Chest. 1972;62:388–93.CrossRefPubMed
3.
go back to reference Morrell MT, Dunnill MS. The post-mortem incidence of pulmonary embolism in a hospital population. BJS. 1968;55:347–52.CrossRef Morrell MT, Dunnill MS. The post-mortem incidence of pulmonary embolism in a hospital population. BJS. 1968;55:347–52.CrossRef
5.
go back to reference Pineda LA, Hathwar VS, Grant BJB. Clinical suspicion of fatal pulmonary embolism. Chest. 2001;120:791–5.CrossRefPubMed Pineda LA, Hathwar VS, Grant BJB. Clinical suspicion of fatal pulmonary embolism. Chest. 2001;120:791–5.CrossRefPubMed
6.
go back to reference Goldhaber SZ, Hennekens CH, Evans DA, Newton EC, Godleski JJ. Factors associated with correct antemortem diagnosis of major pulmonary embolism. Am J Med. 1982;73(6):822.CrossRefPubMed Goldhaber SZ, Hennekens CH, Evans DA, Newton EC, Godleski JJ. Factors associated with correct antemortem diagnosis of major pulmonary embolism. Am J Med. 1982;73(6):822.CrossRefPubMed
7.
go back to reference Freiman DG, Suyemoto J, Wessler S. Frequency of pulmonary thromboembolism in man. N Engl J Med. 1965;272:1278–80.CrossRefPubMed Freiman DG, Suyemoto J, Wessler S. Frequency of pulmonary thromboembolism in man. N Engl J Med. 1965;272:1278–80.CrossRefPubMed
8.
go back to reference Rubinstein I, Murray D, Hoffstein V. Fatal pulmonary emboli in hospitalized patients: an autopsy study. Arch Intern Med. 1988;148(6):1425.CrossRefPubMed Rubinstein I, Murray D, Hoffstein V. Fatal pulmonary emboli in hospitalized patients: an autopsy study. Arch Intern Med. 1988;148(6):1425.CrossRefPubMed
9.
go back to reference Stein PD, Henry JW. Prevalence of acute pulmonary embolism among patients in a general hospital and at autopsy. Chest. 1995;108:978–81.CrossRefPubMed Stein PD, Henry JW. Prevalence of acute pulmonary embolism among patients in a general hospital and at autopsy. Chest. 1995;108:978–81.CrossRefPubMed
10.
go back to reference Alpert JS, Smith R, Carlson CJ, Ockene IS, Dexter L, Dalen JE. Mortality in patients treated for pulmonary embolism. JAMA. 1976;236:1477–80.CrossRefPubMed Alpert JS, Smith R, Carlson CJ, Ockene IS, Dexter L, Dalen JE. Mortality in patients treated for pulmonary embolism. JAMA. 1976;236:1477–80.CrossRefPubMed
11.
go back to reference Goldhaber SZ, Savage DD, Garrison RJ, Castelli WP, Kannel WB, PM MN, et al. Risk factors for pulmonary embolism: the Framingham study. Am J Med. 1983;74:1023–8.CrossRefPubMed Goldhaber SZ, Savage DD, Garrison RJ, Castelli WP, Kannel WB, PM MN, et al. Risk factors for pulmonary embolism: the Framingham study. Am J Med. 1983;74:1023–8.CrossRefPubMed
12.
go back to reference Gibson TN, Shirley SE, Escoffery CT, Reid M. Discrepancies between clinical and postmortem diagnoses in Jamaica: a study from the University Hospital of the West Indies. J Clin Pathol. 2004;57:980–5.CrossRefPubMedPubMedCentral Gibson TN, Shirley SE, Escoffery CT, Reid M. Discrepancies between clinical and postmortem diagnoses in Jamaica: a study from the University Hospital of the West Indies. J Clin Pathol. 2004;57:980–5.CrossRefPubMedPubMedCentral
14.
go back to reference Dismuke SE, VanderZwaag R. Accuracy and epidemiological implications of the death certificate diagnosis of pulmonary embolism. J Chronic Dis. 1984;37:67–73.CrossRefPubMed Dismuke SE, VanderZwaag R. Accuracy and epidemiological implications of the death certificate diagnosis of pulmonary embolism. J Chronic Dis. 1984;37:67–73.CrossRefPubMed
18.
go back to reference Berlot G, Calderan C, Vergolini A, Bianchi M, Viviani M, Bussani R, et al. Pulmonary embolism in critically ill patients receiving antithrombotic prophylaxis: a clinical-pathologic study. J Crit Care. 2011;26:28–33.CrossRefPubMed Berlot G, Calderan C, Vergolini A, Bianchi M, Viviani M, Bussani R, et al. Pulmonary embolism in critically ill patients receiving antithrombotic prophylaxis: a clinical-pathologic study. J Crit Care. 2011;26:28–33.CrossRefPubMed
19.
Metadata
Title
The autopsy and diagnosis of pulmonary thrombo-embolism
Author
Milton J. Micallef
Publication date
01-06-2018
Publisher
Springer US
Published in
Forensic Science, Medicine and Pathology / Issue 2/2018
Print ISSN: 1547-769X
Electronic ISSN: 1556-2891
DOI
https://doi.org/10.1007/s12024-018-9950-5

Other articles of this Issue 2/2018

Forensic Science, Medicine and Pathology 2/2018 Go to the issue