title: Changes in the incidence, case fatality rate, and characteristics of symptomatic perioperative pulmonary thromboembolism in Japan: Results of the 2002-2011 Japanese Society of Anesthesiologists Perioperative Pulmonary Thromboembolism (JSA-PTE) Study.
abstract: OBJECTIVE
  This study aimed to examine the incidence, case fatality rate, and characteristics of perioperative symptomatic pulmonary thromboembolism (PS-PTE) throughout Japan.
  
  
  METHODS
  From 2002 to 2011, confidential questionnaires were mailed annually to all Japanese Society of Anesthesiologists-certified training hospitals for data collection to determine the incidence and case fatality rate of PS-PTE patients. Data from 10,537 institutions in which a total of 11,786,489 surgeries had been performed were analyzed using the Mann-Whitney and Chi-square tests.
  
  
  RESULTS
  In total, 3,667 PS-PTE cases were identified. The average incidence of PS-PTE was 3.1 (2.2-4.8) per 10,000 surgeries, and the average case fatality rate was 17.9% (12.9-28.8%). The incidence of PS-PTE began to significantly decrease in 2004 compared with that of 2002 (0.0036 vs. 0.0044%: p < 0.01). The case fatality rate temporarily increased toward 2005 (17.9 to 28.8%); however, it gradually decreased since 2008 (15.7%) and was the lowest (12.9%) in 2011. Regarding the trends in prophylaxis, the rate of mechanical prophylaxis increased significantly in 2003 compared with that of 2002 (59.5 vs. 35.0%: p < 0.01), and almost plateaued (73.1-83.1%) after 2004. Furthermore, the rate of pharmacological prophylaxis started increasing in 2008 (17.6%) and reached around 30% after 2009 (28.8-30.2%).
  
  
  CONCLUSIONS
  The results of our 10-year survey study show that the incidence of PS-PTE decreased significantly since 2004, and the case fatality rate seemed to show a downward trend since 2008. Major changes in the distribution of prophylaxis in PS-PTE patients were observed.
authors.affiliation: Department of Anesthesiology, Kitasato University, School of Medicine, Sagamihara, 2520375, Japan. masa9618@yahoo.co.jp.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Kuroiwa
authors.affiliation: Department of Anesthesiology and Resuscitology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Morimatsu
authors.affiliation: Department of Anesthesiology, School of Medicine, Keio University, Tokyo, Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Tsuzaki
authors.affiliation: Blood Center, Miyazaki Red Cross Society, Miyazaki, Japan.
authors.forename: Kazuo
authors.initials: K
authors.lastname: Irita
authors.affiliation: Division of Clinical Medical Science, Department of Anesthesiology and Critical Care, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan.
authors.forename: Michiyoshi
authors.initials: M
authors.lastname: Sanuki
authors.affiliation: Department of Anesthesiology and Intensive Care Medicine, Kawasaki Medical School, Kurashiki, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Nakatsuka
authors.affiliation: Department of Clinical Cardiovascular Research, Mie University Graduate School of Medicine, Tsu, Japan.
authors.forename: Mashio
authors.initials: M
authors.lastname: Nakamura
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010820:Physicians; D011183:Postoperative Complications / Q000453:epidemiology*; D011655:Pulmonary Embolism / Q000453:epidemiology*; D012307:Risk Factors; D012955:Societies, Medical; D011795:Surveys and Questionnaires; D055815:Young Adult