Fatal pulmonary embolism in hospitalized patients. Clinical diagnosis versus pathological confirmation

Cláudio Tinoco Mesquita, José Laerte Boechat Morandi Júnior, Flávia Teixeira Perrone, Cláudia da Silva Oliveira, Lavínia J. Barreira, Sônia Santos C. A Nascimento, Raul Carlos Pareto Júnior, Evandro Tinoco Mesquita
1999 Arquivos Brasileiros de Cardiologia  
Objective -To assess the incidence of fatal pulmonary embolism (FPE), the accuracy of clinical diagnosis, and the profile of patients who suffered an FPE in a tertiary University Hospital. Methods -Analysis of the records of 3,890 autopsies performed at the Department Results -Among the 3,980 autopsies, 109 were cases of clinically suspected FPE; of these, 28 cases of FPE were confirmed. FPE accounted for 114 deaths, with clinical suspicion in 28 cases. The incidence of FPE was 2.86%. No
more » ... as 2.86%. No difference in sex distribution was noted. Patients in the 6 th decade of life were most affected. The following conditionswere more commonly related to FPE: neoplasias (20%) and heart failure (18.5%). The conditions most commonly misdiagnosed as FPE were pulmonary edema (16%), pneumonia (15%) and myocardial infarction (10%). The clinical diagnosis of FPE showed a sensitivity of 25.6%, a specificity of 97.9%, and an accuracy of 95.6%. Conclusion -The diagnosis of pulmonary embolism made on clinical grounds still has considerable limitations.
doi:10.1590/s0066-782x1999000900001 fatcat:r5p6g6664reqpcizvjrkxaiqza