Article
Fatal Pulmonary Embolism and Its Risky Factors
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Authors
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P. Zonca
- Department of Surgery, Municipal Hospital Ostrava, Ostrava, The Czech Republic
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M. Banik
- Department of Pathology, Municipal Hospital Ostrava, Ostrava, The Czech Republic
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T. Maly
- Department of Surgery, Municipal Hospital, Trinec, The Czech Republic
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M. Lerch
- Department of Surgery, Municipal Hospital Ostrava, Ostrava, The Czech Republic
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P. Gazdik
- Department of Surgery, Municipal Hospital Ostrava, Ostrava, The Czech Republic
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P. Klimecky
- Department of Surgery, Municipal Hospital Ostrava, Ostrava, The Czech Republic
| Published: | June 15, 2005 |
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Outline
Text
Introdution
The evaluation of the incidence of fatal pulmonary embolism in our surgical department and analysis of its risky factors.
Materials
Retrospectively, we have evaluated the incidence of fatal pulmonary embolism in the patients operated in the surgical department from year 1979 to 2003. Altogether 62.087 patients were operated during these years (average 2586.9 per year). We have used the database of pathology department for our evaluation. We evaluated the incidence of the risky factors in patients with pulmonary embolism. The multivariate analysis was performed. The following factors had statistical significance: established genetic disposition, trombembolism in the history, age higher than 40 years, obesity, varicosity, long term imobilisation, malignancy, peroral contraception, blood group A, B, AB, gravidity, surgery lasting for longer than 2 hours, obstructive cardiac valve complaint and sepsis. In the eighties, we had used mannitol or rheodextran for the prevention of deep venous thrombosis. At the end of eighties, the high molecular heparin came, and from the end of nineties, we use the low molecular heparin.We also present cases of successful surgical treatment of deep venous thrombosis and recommendation of its prevention.
Results
3312 patients died during the observed period. 294 patients died of pulmonary embolism during the observed period (age range from 21 to 97). The percentage of pulmonary embolism in all cases of death was 8.9%. The percentage of pulmonary embolism in all the operated patients was 0.47%. The level of pulmonary embolism mortality was the same in all the observed years despite the changes in embolism prevention (p=0.05).
Discussion
Thrombosis of the deep veins of leg is a serious illness with possible fatal complications thanks to pulmonary embolism. In the surgery, it represents a dreaded complication in connection with the treatment of the basic illness. We can explain the same level of pulmonary embolism mortality per year in the observed period by the usage of a more advanced prophylaxis technique on one side and the more extensive surgery, and the population with higher age on the other hand.
