In-hospital mortality from pulmonary thromboembolism in a multidisciplinary hospital according to autopsy data

Background. Pulmonary embolism (PE) is a serious complication of acute venous thrombosis. The true prevalence of PE is still not fully established, and data on postmortem diagnosis of PE often differ significantly from each other.

Aim. Identification of the real incidence and features of PE based on autopsy data from patients who died at Saint Petersburg Dzhanelidze Research Institute of Emergency Medicine in 6-years period of time.

Materials and methods. We studied 8,406 protocols of autopsy of patients who died in Saint Petersburg Dzhanelidze Research Institute of Emergency Medicine in 2018–2023. Of these, those cases in which there PE were occurred identified and analyzed. Results were statistically processed.

Results. The rate of pulmonary thromboembolism was 15.4% from all autopsies, in 10.1% of cases PE was the direct cause of death. 61.4% of females and 38.6% of males died, p < 0.05. The average age of all patients was 72.5 ± 0.4 years. 81.0% of patients were older 60 years. The ratio of males and females under the age of 60 was 1.8:1, while among all older deaths this indicator was 1:2.1. In postmortem clinical diagnoses of the deceased, PE appeared only in 59.2% of autopsies, 30.4% of the deceased were not diagnosed, and 10.4% were questionable. In 2020–2022, the number of deaths of patients with COVID-19 amounted to 20.5% of the total number of patients with PE during this period. There was no relative increase in deaths from PE and no relative change in the distribution of these patients by gender and age.

Conclusion. According to the results of our research PE was the direct cause of death in every tenth person who died in a multidisciplinary hospital. Among the deceased patients with PE under the age of 60, males significantly prevailed, while females significantly prevailed at an older age. There was no relative increase in the number of patients with PE during the COVID-19 pandemic in a multidisciplinary hospital. PE remains a difficult condition to diagnose and requires specialist’s opinion to be more vigilant about this complication.