Pulmonary Thromboembolism and Its Clinical Predisposing Factors in Autopsy Cases

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We examined the lungs from 214 autopsy cases, mainly elderly, to estimate the incidence of pulmonary thromboembolism and its correlation with clinical features. At autopsy, each lung was distended and fixed by transbronchial infusion with 10% formalin, cut coronally into 5 mm thick slices, and inspected for thromboembolism. Clinical data of every case were reviewed with emphasis on disseminated intravascular coagulation (DIC), sepsis, shock, malignancy, and cardiovascular disorders. Pulmonary thromboembolism was found in 86 cases (40.2%) . The total number of the thromboemboli was 194, and most of them were distal to the subsegmental pulmonary artery. Histologically confirmed complete pulmonary infarction was found in 10 cases (4.7%) . Statistically significant correlation existed between the thromboembolism and DIC (p<0.01), shock, sepsis, and malignancy (p<0.05) . Many patients in a state of shock or sepsis were concomitantly complicated with DIC. We concluded that blood hypercoagulability was critical to the formation of pulmonary thromboembolism.
昭和大学・昭和医学会の論文