title: Triggers of acute pulmonary thromboembolism developed in hospital, with focusing on toilet activities as triggering acts.
abstract: BACKGROUND
  The recognition of the trigger which is the action leading to the occurrence of acute pulmonary thromboembolism (APTE) is important to perform early diagnosis and early management of APTE.
  
  
  RESULTS
  The trigger of APTE in 138 patients who developed APTE in hospital was investigated. The triggers of APTE were specified in 57 patients. Approximately half of these patients developed APTE during toilet activities (defecation and micturition). Mortality of the patients with APTE associated with toilet activities was 33%. APTE associated with toilet activities was independently related to a recent major surgery, heart diseases and a recent angiography.
  
  
  CONCLUSIONS
  Defecation and micturition would be common triggers of APTE after operation and angiography, especially in patients with cardiac dysfunction.
authors.affiliation: The First Department of Internal Medicine, Mie University, Edobashi 2-174, Tsu 514-8507, Japan.
authors.forename: Norikazu
authors.initials: N
authors.lastname: Yamada
authors.forename: Mashio
authors.initials: M
authors.lastname: Nakamura
authors.forename: Ken
authors.initials: K
authors.lastname: Ishikura
authors.forename: Masahiro
authors.initials: M
authors.lastname: Ota
authors.forename: Takahiro
authors.initials: T
authors.lastname: Yazu
authors.forename: Satoshi
authors.initials: S
authors.lastname: Ota
authors.forename: Masaaki
authors.initials: M
authors.lastname: Ito
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Fujioka
authors.forename: Naoki
authors.initials: N
authors.lastname: Isaka
authors.forename: Takeshi
authors.initials: T
authors.lastname: Nakano
mesh_terms: D000208:Acute Disease; D000368:Aged; D003672:Defecation; D005260:Female; D006760:Hospitalization; D006801:Humans; D016015:Logistic Models; D008297:Male; D011655:Pulmonary Embolism / Q000209:etiology*; D012189:Retrospective Studies; D014554:Urination