Abstract
Patients, who died due to pulmonary thromboembolism (PTE), may present different clinical manifestations and symptoms depending on their underlying diseases and comorbidities. The aim of this study was describe and associated demographic and etiologic data, anatomic pathological findings and in-vivo manifestations (Acute Respiratory Failure [ARF], Hemodynamic Instability [HI] or Sudden Death) from autopsy reports of PTE patients.
Methods: We reviewed 291 autopsies of patients whose cause of death was PTE. The following data were obtained: age, sex, clinical in-vivo manifestations, post-mortem pathological patterns and main associated underlying diseases.
Results: The median age was 64 years, 127 men and 164 women. Pulmonary histopathological changes were: diffuse alveolar damage (DAD), pulmonary edema (PE), alveolar hemorrhage (AH) and lympho/plasmacytic interstitial pneumonia (LPIP). The most common clinical manifestation was ARF (28.9%), followed by SD (27.5%) and HI (26.8%). The most prevalent pulmonary finding was PE (26.8%). Chronic Obstructive Pulmonary Disease was positively correlated to LPIP (p=0.04). Linking in-vivo manifestations to pulmonary changes were found significative relations between: ARF and PE (OR=2.99; p=0.01); ARF and AH (OR=2.70; p=0.04); ARF and DAD (OR=8.79; p=0.03); HI and HA (OR=3.38, p=0.01) and HI and DAD (OR=11.43; p=0.02).
Conclusions: The understanding of pulmonary physiopathological mechanism involved with each PTE-associated disease can improve diagnosis in order to offer prompt treatment and reduce mortality.
Financial support: FAPESP, CNPq.
- © 2011 ERS
