An examination of forensic autopsy cases with pulmonary embolism

The aim of this study was to examine the frequency, origin, histopathology, and risk factors of PE, the vascular characteristics causing obstruction and the direct or indirect effect on mortality. A retrospective examination was made of autopsies conducted between 2013 and 2016 in the Malatya Forensic Medicine Group Directorate. Cases determined with PE were evaluated in respect of age, gender, event origin, risk factors, history of hospitalization, size of the vessels obstructed by the thromboembolism and histopathological examination. Pulmonary embolism is a frequently seen complication during hospitalization and is one of the leading causes of preventable hospital deaths. When advanced diagnostic methods are used, deep vein thrombosis is determined in 79% of PE patients. The annual incidence in Turkey is approximately 15/10,000 cases, which is comparable to rates in western populations. Although PE is seen more at advanced ages, attention must be paid to young cases with trauma-related injuries. Histopathological examination is of the greatest importance as the mortality rate associated with large vessel obstruction is high and obstructions in small vessels alone also contribute to mortality.

___

1. Davidson BL. Risk assessment and prophylaxis of venous thromboembolism in acutely and/or critically ill patients. Haemostasis 2000;30:77-81.

2. Wagenvoort CA. Pathology of pulmonary thromboembolism. Chest. 1995;107:10-7.

3. Wittram C, Maher MM, Yoo AJ, et al. CT angiography of pulmonary embolism: Diagnostic criteria and causes of misdiagnosis. Radiographics. 2004;24:1219-38.

4. Guidelines on the diagnosis and management of acute pulmonary embolism. Task Force on Pulmonary Embolism, European Society of Cardiology. Eur Heart J. 2014;3033-73.

5. Schonhofer B and Kohler D. PRelevance of deep venous thrombosis of the leg in patients with acute exacerbated COPD. Pneumologie. 1999;53:10-4.

6. Kollef MH, Zahid M, Eisenberg MR. Predictive value of a rapid semiquantitative D-dimer assay in critically ill patients with suspected venous thromboembolic disease. Crit Care Med. 2000;28:414-20.

7. Gosselin MV, Rubin GD, Leung AN, et al. Unsuspected pulmonary embolism: prospective detection on routine helical CT scans. Radiology. 1998;208:9–215.

8. Torbicki A, Van Beek EJR, Charbonnier B, et al. Guide¬lines on diagnosis and management of acute pulmonary embolism Eur Heart J. 2000;21:1301- 36.

9. Palevsky HL, Kelly MA, Fishman AP. Pulmonary thromboembolic disease. In: Fishman AP, ed. Fishman’s Pulmonary Diseases and Disorders. 3rd ed. New York: Mc Graw-Hill. 1998:1297-329.

10. Arseven O. Akut pulmoner embolizm. Türktaş H, Ekim N, eds. Göğüs Hastalıkları Acilleri. Ankara: Bilimsel Tıp, 2000;247-65.

11. British Thoracic Society Standards of Care Committee Pulmonary Embolism Guideline Development Group. British thoracic society guidelines for the management of suspected acute pulmonary embolism. Thorax. 2003;58:470- 84.

12. Torbicki A, Perrier A, Konstantinides S, et al. Guidelines on the diagnosis and management of acute pulmonary embolism: The Task Force for the Diagnosis and Man¬agement of Acute Pulmonary Embolism of the European Society of Cardiology (ESC) (practice guideline). Eur Heart J. 2008;29:2276-315.

13. Anderson FA, Wheeler HB, Goldberg RJ, et al. The significance of critical care errors in causing preventable death in trauma patients in trauma system. J Trauma. 1991;31:813-9.

14. Palla A, Petruzelli S, Donnamaria V et al. The role of suspicion in the diagnosis of pulmonary embolism. Chest. 1995;107:21-4.

15. Törő K, Pongrácz R, Bartholy J, et al. Evaluation of meteorological and epidemiological characteristics of fatal pulmonary embolism. Int J Biometeorol. 2016;60:351–9.

16. Ruppert ADP, Soeiro AM, Almeida MCF, et al. Clinical manifestations and pulmonary histopathological analysis related to different diseases in patients with fatal pulmonary thromboembolism: an autopsy study. Emerg Med. 2014;6:15–21.

17. Yun JL and Li XY. Prevalence of pulmonary embolism at autopsy among elderly patients in a Chinese general hospital, J Geriat Cardiol. 2016;13:894- 8.

18. Yakar A, Yakar F, Ziyade N, Yıldız M, Üzün İ. Cardiac Findings of Pulmonary Thromboembolism by Autopsy: A Review of 48 Cases, Med Sci Monit. 2016;22:1410-4.

19. Yakar A, Yakar F, Ziyade N, et al.Fatal pulmonary thromboembolism, Eur Rev Med Pharmacol Sci. 2016;20:1323-6.

20. Goldhaber SZ, Visani L, De Rosa M. Acute pulmonary embolism: clini¬cal outcomes in the International Cooperative Pulmonary Embolism Registry (ICOPER). Lancet. 1999;353:1386–9.

21. Anderson FA, Wheeler WB, Goldberg RJ, et al. A population-based perspective of the hospital incidence and case-fatality rates of deep vein thrombosis and pulmonary embolism. The Worcester DVT study. Arch Int Med. 1991;151:933-8.

22. Jackowski C, Grabherr S, Schwendener N. Pulmonary thromboembolism as cause of death on unenhanced postmortem 3T MRI, Eur Radiol. 2013;23:1266-70.

23. Ramzi DW and Leeper KV. DVT and pulmonary embolism: Part I. Diagnosis Am Fam Physician. 2004;69:2829-36.

24. Cook DJ Crowther MA, Meade MO, et al. Prevalence incidence, and risk factors for venous thromboembolism in medical-surgical intensive care unit patients. J Crit Care. 2005;20:309-13.

25. Manganelli D, Palla A, Donnamaria V et al. Clinical features of pulmonary embolism. Chest. 1995;107:25-3.
Medicine Science-Cover
  • ISSN: 2147-0634
  • Yayın Aralığı: Yılda 4 Sayı
  • Başlangıç: 2012
  • Yayıncı: Effect Publishing Agency ( EPA )
Sayıdaki Diğer Makaleler

Care burden and quality of life of home caregivers

Neşe KARAKAŞ, Erkan PEHLİVAN

Efficacy of proximal crescentic, supination osteotomy in the surgical treatment of moderate and severe hallux valgus deformity

Vugar NABI, Cengiz ALDEMİR

Histopathological features of chronic hepatitis B reactivation

Remzi BEŞTAŞ, Kendal YALÇIN

Synthesis of the compound 4-Coumarinyl 4-methoxybenzoate and molecular docking study against COVID-19

Pelin KOPARIR

The investigation of clinical and radiological findings of igG4-related autoimmune pancreatitis

Mustafa KOÇ

Efficiency of mechanical thrombectomy in acute ischemic stroke patients

Mehmet KOLU, İsmail Okan YILDIRIM, Ahmet Turan KAYA, Suat KAMIŞLI, Yüksel KAPLAN, Mehmet Akif DURAK, Şükrü GÜRBÜZ, Kaya SARAÇ

An examination of forensic autopsy cases with pulmonary embolism

Ahmet Sedat DÜNDAR, Mücahit ORUÇ, İsmail ALTIN, Bedirhan Sezer ÖNER, Semih PETEKKAYA, Emine TÜRKMEN ŞAMDANCI, Osman CELBİŞ

Evaluation of risk factors of diagnostic failure in fine needle biopsy in pulmonary nodules; conventional computed tomography versus computed tomography flouroscopy

Mehmet KOLU, İsmail Okan YILDIRIM

Smoking behavior and attitudes of patient’s relatives in the pediatric emergency rooms- a multi-center study

Selçuk Yasin YILDIZ, Onur ÖZTÜRK, Muhammet BULUT, Arzu AYRALER, Muhammet Ali ORUÇ, Bahadır YAZICIOĞLU, Mustafa ÜNAL, Gülşah ÖZTÜRK, Mi̇kai̇l ÖZDEMİR

Demographic and clinical features of Covid-19 cases in Serik, Turkey

Mustafa ALTINTAŞ, Gülsüm AKDENİZ, Bilgehan GÜRBÜZ, Yusuf Ali KARA, Osman CELBİŞ