Postoperative pulmonary embolism: timing, diagnosis, treatment, and outcomes.
BACKGROUND
Postoperative pulmonary embolism (PE) remains a major health concern. The purpose of our study was to evaluate our experience with postoperative PE.


METHODS
We retrospectively reviewed the medical records of patients who had a postoperative PE at our institution.


RESULTS
Our study included 115 patients. Prophylaxis was administered preoperatively in 31% of patients and postoperatively in 56% of patients. The diagnosis was obtained by computed tomography scan in 74 patients (64%), ventilation-perfusion scan in 24 patients (21%), angiogram in 8 patients (7%), and other modalities in 9 patients (8%). The time elapsed between surgery and the diagnosis of PE varied significantly by patient age (<40 y: 3 d, compared with 40-60 y: 11 d; P = .02). The majority of patients with PE were treated with anticoagulation (83%). Morbidity and mortality rates both were 9%.


CONCLUSIONS
Age has a significant impact on the timing of postoperative PE, with the majority of cases being diagnosed with a computed tomography scan, and treated with anticoagulation.
Hope
William W
WW
Department of Surgery, Carolinas Medical Center, 1000 Blythe Blvd, MEB #601, Charlotte, NC 28203, USA.
Demeter
Bradley L
BL
Newcomb
William L
WL
Schmelzer
Thomas M
TM
Schiffern
Lynnette M
LM
Heniford
B Todd
BT
Sing
Ronald F
RF
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000008:administration & dosage / Q000009:adverse effects; D015897:Comorbidity; D017128:Embolectomy; D005260:Female; D006493:Heparin / Q000008:administration & dosage / Q000009:adverse effects; D006801:Humans; D006937:Hypercholesterolemia / Q000453:epidemiology; D006973:Hypertension / Q000453:epidemiology; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology; D011183:Postoperative Complications / Q000453:epidemiology*; D011655:Pulmonary Embolism / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control / Q000628:therapy; D012189:Retrospective Studies; D013997:Time Factors; D036542:Tomography, Spiral Computed; D016306:Vena Cava Filters
D000925:Anticoagulants; D006493:Heparin