Prevalence of pulmonary embolism at autopsy among elderly patients in a Chinese general hospital

OBJECTIVES: To investigate the prevalence and characteristics of pulmonary embolism (PE) at autopsy in a Chinese general hospital over a period of 10 years, and to evaluate the antemortem achievement of the prophylaxis, diagnosis, and treatment of PE. METHODS: All medical records of deaths from the West Branch of the Chinese People's Liberation Army (PLA) General Hospital were retrospectively reviewed, for the period of January 1, 2006 to December 31, 2015. Cases in which autopsies had been performed were identified and further analyzed. The numbers and detailed characteristics of patients who had PEs were noted. Prophylactic measures, along with diagnosis and treatment of PE, were recorded, if performed. RESULTS: During the 10-year period, 1057 patients died in the study hospital and 278 necropsies were performed (autopsy rate: 26.3%). Nine patients were found to have PE (3.2%), and in seven of these patients (2.5%), the PE was considered to be fatal. Embolisms were found in the trunk and bilateral main branches of the pulmonary artery tree in all seven of the fatal PE cases. Right intracardiac thrombosis was detected in five of the nine PE patients (55.6%). All patients with PE had been hospitalized in medical departments, and only one had undergone surgery during hospitalization. Antemortem prophylaxis was performed in two of the nine PE cases (22.2%). None of the 9 patients had received a clinical diagnosis of PE before death. CONCLUSIONS: The incidence of and death rate associated with PE may vary among different races and regions. Continuous monitoring of PE by means of necropsy in certain representative medical institutions is necessary.