Key result
Pulmonary embolism accounts for ~11% of autopsy deaths but is rarely suspected antemortem.
Why the study?
The diagnosis and treatment of fatal pulmonary embolism remain challenging, with frequent missed diagnoses and underutilization of thrombolytic therapy despite advances in prophylaxis.
Population
982 postmortem cases including 108 fatal PE cases at an academic medical center in San Diego from 2002 to 2012
Comparison
Antemortem diagnosis and treatment versus missed diagnosis and no treatment of PE
Design
Systematic autopsy case review with chart analysis at a single academic center
Authors
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Fatal PE frequently missed antemortem despite prophylaxis; leaves open whether improved detection algorithms reduce mortality.
Observational (n=982)
No
Despite advances in DVT prophylaxis, fatal pulmonary embolism remains a common autopsy finding (11%) and is frequently missed or undertreated antemortem.
Sweet et al. (2013) conducted an observational in Fatal pulmonary embolism (n=982). Pulmonary embolism was evaluated on Rate of death caused by pulmonary embolism (95% CI 9.01-12.99). Pulmonary embolism was identified as the mechanism of death in 11% (95% CI 9.01-12.99%) of 982 autopsy cases, with antemortem diagnosis considered in only 31% of eligible cases.
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