Table: PE Autopsy Studies Author Location & year Total # Autopsies # Autopsies with PE % of PE's missed until autopsy Comments ===== Awotedu[18] Ibadan, Nigeria; 1992 1579 60 84% Fatal PE's from autopsy cases 1985 - 1989 ===== Bussani[19] Trieste; 1990 27,410 5232 unk 41% of the PE's were bilateral and 27% were the cause of death. ===== Deganuto[20] Italy; 1980 unk 331 82% no comments ===== Diebold[21] Luebeck; 1991 5039 1500 unk 628 (42.5%) of the PE's were fatal. ===== Dismuke[22] Memphis; 1986 3,412 204 > 60% only includes fatal emboli ===== Garcia-Rodeja[23] Madrid; 1990 2333 63 unk no comments ===== Gery[20] France; 1940 unk 222 66% no comments ===== Goldhaber[16] Brigham Hospital, MA; 1982 1455 54 70% All anatomically major PE cases from years 1973 - 1977 Dx was missed in 90% of patients > 90 yrs ===== Goldhaber[16] Brigham Hospital, MA; 1982 1455 21 100% Subset: major PE cases from years 1973 - 1977 who had both pneumonia and PE at autopsy. ===== Goldhaber[24] Brigham Hospital, MA; 1987 unk 56 55% Includes patients with solid tumors and PE between 1978 - 1982 ===== Gross[17] Mt. Sinai, New York; 1988 234 19 61% Institutionalized elderly patients in whom PE was the cause of death. ===== Hauch[25] Denmark; 1990 1603 74 unk Autopsies from 1986 ===== Hjorth[26] 1995 424 unk unk "Compared to autopsy, the lowest sensitivity of clinical dx was for PE and the lowest accuracy was for pneumonia." ===== Ilic[27] 1992 3629 533 74% Dx missed in 74% of all acute PE's seen at autopsy 1980 - 1990, and missed in 69% of 395 patients with PE as the cause of death ===== Illig[28] 1978 23 3 100% Autopsy study of patients clinically believed to have died from asthma ===== Ishikawa[29] Tokyo; 1993 544 7 100% Only includes fatal saddle emboli ===== Jorgensen[30] Denmark; 1989 1615 210 66% 210 total emboli; Diagnosis missed in 73 (66%) of fatal emboli ===== Karwinski[31] Bergen, Norway; 1989 21,530 1938 84% Autopsy cases 1960 -1984: "most were the immediate cause of death" ===== Lindblad[32] Malmo, Sweden; 1991 unk 260 'Most' Cases from 1987 36% were fatal; 35% were contributory; 29% were incidental ===== Lindblad[33] Malmo, Sweden; 1991 1234 391 'Most' Cases from 1981 - 1988 "the diagnosis was rarely clinically apparent before death" 29% were fatal; 27% contributed to death; 44% were incidental ===== McKelvie[34] Fitzroy, Victoria; 1994 132 16 81% Clinical symptoms of PE were documented in the chart (but ignored) in one-fourth of the fatalities. ===== Morgenthaler[35] Rochester, New York; 1995 2427 92 68% Includes only deaths due to acute massive PE ===== Morpurgo[20] Milan, Italy; 1980 unk 100 83% no comments ===== Panasiuk[36] Kierownik; 1993 13216 727 75% PE was seen in 31% of autopsies in older patients ages 71 - 79 years ===== Passarino[20] Italy; 1982 unk 546 92% no comments ===== Presti [37] Colorado Springs; 1990 7753 269 unk Includes only chronic-massive or acute-massive PE. "a correct antemortum diagnosis was rare" ===== Riedel[38] Prague; 1980 unk 18.5% of autopsies 70% PE missed in 70% overall, missed in 57% of PE's that were the cause of death, & missed in 54% of those with good long-term prognosis ===== Ruan[39] Beijing; 1991 unk 100 87% 100 sequential deaths caused by PE; 35% had sudden death ===== Rubinstein[40] Toronto; 1988 1276 44 68% Only includes cases where PE was the cause of death ===== Sandler[41] Sheffield; 1989 2388 239 97% Only includes cases where PE was the cause of death. 97% of patients had no antemortum investigation for thromboembolic disease ===== Sandritter[42] 1980 1096 50% Dx was missed in 50% of cases where PE was the cause of death ===== Sperry[43] Albuquerque; 1990 46,512 586 54% Study of 586 cases where PE was the cause of death on the death certificate; roughly half of the patients had autopsy ===== Svendsen[44] Norway; 1991 264 95 88% Population of patients who had autopsy after hospitalization for at least 5 days and had circulatory disturbance of the lower limbs. PE was the cause of death in 85% of the patients with PE. References: