Circadian pattern of post-surgical fatal pulmonary embolism.
BACKGROUND
The circadian distribution of fatal pulmonary thromboembolism in general surgical patients is unknown.


METHODS
One hundred consecutive cases of pulmonary embolism, with reliable clinical notes and data, were studied (67 men and 33 women; mean age 71 years). Only post-surgical cases were considered in this analysis. Patients had undergone elective (78%) or emergency abdominal surgery (22%). Correct prophylaxis (according to the Windsor Consensus Statement) had been used in 12%. Cases were grouped according to the time of onset of signs and symptoms related to pulmonary embolism at one hour intervals.


RESULTS
The maximum incidence of fatal pulmonary embolism was between 7.00 a. m. and 1.00 p. m. with the highest peaks at 9.00 and 11.00 a. m. 9% of deaths) (P < 0.02). When results from this study were compared to a previous study no significant difference was observed between the distribution profile of cases from general medical wards and surgical wards.


CONCLUSIONS
It appears that in surgical patients there is a circadian pattern in pulmonary embolism as already documented in medical patients.
Belcaro
G
G
Cardiovascular Institute, Chieti University.
Nicolaides
A N
AN
Geroulakos
G
G
Artese
L
L
Laurora
G
G
Cesarone
M R
MR
de Sanctis
M T
MT
Incandela
L
L
Ricci
A
A
Ramaswami
G
G
Willows
L
L
D000368:Aged; D002423:Cause of Death; D002940:Circadian Rhythm; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D008297:Male; D011183:Postoperative Complications / Q000401:mortality*; D011655:Pulmonary Embolism / Q000401:mortality*; D016019:Survival Analysis