title: Fatal pulmonary embolism after total hip arthroplasty: diurnal variations.
abstract: From 1970 through 1986, a total of 18,104 Charnley low-friction arthroplasties were performed; of these, 122 deaths occurred from pulmonary embolism within 1 year of surgery. Diagnosis was confirmed by postmortem examination in 71% of cases. The exact time of the onset of the complication was recorded in 90 cases. In 74 (82%) cases, the time of collapse occurred during the 7-hour period from 9:00 AM to 4:00 PM, and in 16 (18%) cases, it occurred in the 17-hour period from 4:00 PM to 9:00 AM. The patient's activity at the time of collapse was recorded in 73 cases. Sixty (82%) were mobile, 3 were in the bathroom, and 10 (14%) were in bed. Sixty-six (70.2%) patients died within 1 hour of the onset of symptoms.
authors.affiliation: John Charnley Research Institute, Wrightington Hospital, Lancashire, United Kingdom.
authors.forename: B M
authors.initials: BM
authors.lastname: Wroblewski
authors.forename: P D
authors.initials: PD
authors.lastname: Siney
authors.forename: P A
authors.initials: PA
authors.lastname: Fleming
mesh_terms: D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects* / Q000379:methods; D002423:Cause of Death; D002940:Circadian Rhythm; D005260:Female; D006801:Humans; D008297:Male; D011655:Pulmonary Embolism / Q000209:etiology* / Q000401:mortality* / Q000503:physiopathology; D012042:Registries; D018570:Risk Assessment; D006113:United Kingdom