Venous thromboses and pulmonary embolisms in post-mortem series: probable causes by correlations of clinical data and basic diseases

Abstract

In a continuous series (1979-1989) of autopsies (n = 4,077) acute venous thromboses or pulmonary embolisms were found in 966 cases (23.7%). Fresh pulmonary embolisms were present in 758 cases (18.6%) and thromboses without embolisms were demonstrated in 208 (5.1%) autopsies. Fulminant fatal embolism leading to death was found in 598 cases (14.6%). In some cases with embolism (n = 56; 7.4%) a vein thrombosis was not demonstrable. In 62.1% of embolisms thromboses originated from pelvic or femoral veins and in 22.8% from calf veins. A comparison of the series of thromboses with a control group free of thromboses showed significant (p < 0.05) differences: a) thromboses are more frequent in females; b) patient's weight was higher in group with thromboses (59.4 kg versus 56.7 kg); c) the period of rest in hospital was longer in group with thrombosis (19.0 days versus 101.4 days); d) malignancies were more frequent in study group (54.5% versus 47.1%); e) hematocrit was higher in group with thrombosis (39.1% versus 37.5%); f) cases treated with heparin (15,000 IE sc daily) and patients with hepatic insufficiency are overrepresented in control group.