[What factors make the diagnosis of pulmonary thromboembolism difficult?].
A series of 63 cases of fatal acute pulmonary thromboembolism (PTE) with available necropsy study was evaluated The diagnosis was established ante mortem in 20 cases (predictive index 31%). The diagnosis was only suspected in 2 of the 16 patients in whom PTE was associated with pneumonia (predictive index 12.5%, p less than 0.01), in 3 of the 26 cases if PTE associated with neoplasia (predictive index 11.5% p less than 0.01) and in 8 of the 41 cases with terminal disease (predictive index 19.5%, p less than 0.01). On the contrary, thrombophlebitis and relapsing PTE had a significative facilitation effect on the diagnosis (predictive indexes 53.3% and 52.6%, respectively; p less than 0.01). It was concluded that the presence of neoplasia, pneumonia or terminal illness make the diagnosis of pulmonary thromboembolism difficult.
Servicio de Medicina Interna, Hospital La Paz, Facultad de Medicina, Universidad Autónoma de Madrid.
J R
JR
Arribas
F
F
Arnalich
M E
ME
García-Rodeja
A
A
Monereo
C
C
Lahoz
C
C
Gamallo
J J
JJ
Vázquez
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000150:complications / Q000175:diagnosis*
Cuáles son los factores que dificultan el diagnóstico del tromboembolismo pulmonar?