[Fatal pulmonary thromboembolism: is its incidence increasing or diminishing? Analysis of 178 cases from 1971 to 1988].

A retrospective study was undertaken on 178 cases (6.9% out of 2569 autopsies) of fatal pulmonary thromboembolism, 86 males and 92 females, aged 28-87 years (mean age = 71 +/- 13), in whom pulmonary emboli were found at autopsies, performed from 1971 to 1988. Fatal pulmonary thromboemboli means that no other cause of death was found at autopsy, and emboli occluded at least 2 lobar arteries. In 43 cases (24.2%) the fatal pulmonary thromboembolism developed after surgery. Considering the percentage of the cases of fatal pulmonary thromboembolism on the number of autopsies performed every year, the incidence of this disease increased throughout the period under study. There is a significant difference in incidence of fatal pulmonary thromboembolism in the autopsies in years 1971-79 in comparison with the years 1980-88. In fact the fatal pulmonary thromboembolism cases are 5.1% from 1340 autopsies in the period 1971-79, and 8.9% from 1229 autopsies in the period 1980-88. This increase in incidence is due mainly to the fatal pulmonary thromboembolism in the medical patients (from 3.2% to 7.5%) while the postoperative cases show a slight decrease, from 1.9% to 1.4%. The mean age of patients with fatal pulmonary thromboembolism increases in the second period considered. Age and medical treatment are the most important risk factors. In spite of the increasing age of the population and the increased use of major surgery, there is a tendency to constant or decreased incidence of fatal pulmonary thromboembolism, at least in surgical patients.(ABSTRACT TRUNCATED AT 250 WORDS)