Postoperative pulmonary embolism: timing, diagnosis, treatment, and outcomes

Am J Surg. 2007 Dec;194(6):814-8; discussion 818-9. doi: 10.1016/j.amjsurg.2007.08.014.

Abstract

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.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Anticoagulants / administration & dosage
  • Anticoagulants / adverse effects
  • Comorbidity
  • Embolectomy
  • Female
  • Heparin / administration & dosage
  • Heparin / adverse effects
  • Humans
  • Hypercholesterolemia / epidemiology
  • Hypertension / epidemiology
  • Incidence
  • Male
  • Middle Aged
  • Neoplasms / epidemiology
  • Postoperative Complications / epidemiology*
  • Pulmonary Embolism / diagnosis
  • Pulmonary Embolism / epidemiology*
  • Pulmonary Embolism / prevention & control
  • Pulmonary Embolism / therapy
  • Retrospective Studies
  • Time Factors
  • Tomography, Spiral Computed
  • Vena Cava Filters

Substances

  • Anticoagulants
  • Heparin