What is the clinical evidence from this study?

Study design: Observational. Population: Pulmonary embolism (n=2583). Primary outcome: Proportion of deaths adjudged at autopsy to be due to pulmonary embolism (95% CI 1.2-3.3).

What question did this study set out to answer?

To estimate the number of deaths caused by pulmonary embolism and assess the potential impact of caval filters.

August 1, 2011Journal of the Royal Society of MedicineOpen Access

Mortality from pulmonary embolism is decreasing in hospital patients

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Key result

Pulmonary embolism accounted for only 2.0% (95% CI 1.2-3.3%) of adult inpatient deaths undergoing autopsy, suggesting that current risk prevention policies overestimate the level of risk.

Population

186,517 adult inpatient admissions at a large UK teaching hospital between 2007 and 2008, resulting in 2,583…

Design

Cohort

Authors

DKDouglas KopckeNorth Bristol NHS Trust OHOndina HarrymanUniversity of Manchester EBE W BenbowUniversity of Manchester

Discussion

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Implication

May warrant review of inpatient VTE prophylaxis intensity; hypothesis-generating and should not yet change practice without randomized data.

Key Points

To estimate the number of deaths caused by pulmonary embolism and assess the potential impact of caval filters.
Review of autopsy reports from 2007 and 2008
Analysis of death notification records for evidence of pulmonary embolism
Assessment of hospital records for pre-mortem diagnosis of DVT or pulmonary embolism
From 186,517 adult inpatient admissions, 2583 deaths (1.4%) occurred, with 14 deaths (2.0%, 95% CI 1.2–3.3%) confirmed as pulmonary embolism through autopsy.
Pulmonary embolism was noted as a cause of death in 12 (0.7%) of 1773 patients who did not undergo autopsy.
Only five patients had a pre-mortem diagnosis of DVT or pulmonary embolism, indicating limited scope for mortality reduction.

Study Design

Type

Observational (n=2,583)

Multicenter

Structured PICO

Population

186,517 adult inpatient admissions at a large UK teaching hospital between 2007 and 2008, resulting in 2,583 deaths (696 of which underwent autopsy).

Outcome

Proportion of deaths adjudged at autopsy to be due to pulmonary embolismhard clinical

The proportion of hospital deaths caused by pulmonary embolism is low (2.0% of autopsies), suggesting current policies may overestimate the risk and potential benefit of caval filters.

Cite This Study

Kopcke et al. (2011) conducted an observational in Pulmonary embolism (n=2,583). Pulmonary embolism accounted for only 2.0% (95% CI 1.2-3.3%) of adult inpatient deaths undergoing autopsy, suggesting that current risk prevention policies overestimate the level of risk.

synapsesocial.com/papers/6a0d54dc48a82a5ce309b281 https://doi.org/10.1258/jrsm.2011.100395

Topics

Pulmonary embolism

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Implication

May warrant review of inpatient VTE prophylaxis intensity; hypothesis-generating and should not yet change practice without randomized data.

Mortality from pulmonary embolism is decreasing in hospital patients

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Cite This Study

Topics

Mortality from pulmonary embolism is decreasing in hospital patients

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Cite This Study

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