McKelvie P A
Department of Anatomical Pathology, St Vincent's Hospital, Fitzroy, Vic.
Med J Aust. 1994 Feb 7;160(3):127-8.
To determine the prevalence of pulmonary thromboembolism (PE) and underlying risk factors at autopsy, compared with clinical diagnosis.
Retrospective review of autopsy records, death certificates and medical histories.
All 132 patients who underwent autopsy at St Vincent's Hospital, Melbourne, in 1992.
Sixteen cases (12% of autopsies) of PE were found at autopsy. In only two had PE been recorded on the death certificate; in one other, diagnosis had been made before death. Associated pulmonary infarction and/or haemorrhage was found in only six patients with PE. All 16 had at least one underlying risk factor: advanced age, cancer, heart disease, or recent pelvic or abdominal surgery. In four patients with missed PE, clinical records showed episodes consistent with PE. There were four false-positive diagnoses.
Significant undiagnosed pulmonary embolism is not uncommon at autopsy. Many episodes are clinically silent, but the diagnosis should be suspected in at-risk patients with unexplained episodes of dyspnoea and tachycardia.
通过尸检确定肺血栓栓塞症（PE）的患病率及其潜在危险因素，并与临床诊断结果进行比较。
对尸检记录、死亡证明和病史进行回顾性研究。
1992年在墨尔本圣文森特医院接受尸检的132例患者。
尸检发现16例（占尸检总数的12%）PE患者。死亡证明上仅记录了2例PE；另有1例在生前已确诊。仅6例PE患者伴有肺梗死和/或出血。所有16例患者均至少有一种潜在危险因素：高龄、癌症、心脏病或近期盆腔或腹部手术。4例漏诊的PE患者，临床记录显示有与PE相符的症状。有4例假阳性诊断。
尸检时发现未被诊断的严重肺栓塞并不罕见。许多病例临床上无明显症状，但对于有不明原因呼吸困难和心动过速发作的高危患者应怀疑PE诊断。
