Clinical-epidemiological characterization of pulmonary embolism in autopsies of the Medellín Institute of Legal Medicine 2010-2020

Abstract

Introduction: Pulmonary embolism (PE) is a medical complication that has caused high morbidity and mortality for a long time despite having highly effective diagnostic and therapeutic methods for treating it.

Objective: To describe the clinical-epidemiological and anatomopathological characteristics of the diagnosis of PE in corpses that were ingressed in the National Institute of Legal Medicine and Forensic Sciences of Medellín due to sudden death between the period 2010-2020.

Methods: This is a descriptive cohort study carried out through the analysis of sudden death cases with cause of death to be established that were admitted at the Institute. Additionally, a diagnosis of PE was conducted on them and the analyzes were performed with frequencies and summary measures of SPSS 27.0.

Results: From 46.097 legal-medical autopsies of the period studied, 164 cases (0.36%) corresponded to PE. The mean age was 57.0 ± 19.3 years and 51.2% were women. A percentage of 57.9% were natural deaths, 37.2% had trauma, and 36.0% presented another circulatory event. The highest proportion of deaths occurred in living places (47.0%) and public roads (25.6%). In terms of thrombosis, 45.1% occurred in the pulmonary artery, 34.8% in intraparenchymal pulmonary arteries, and 52.4% of the deceased had deep vein thrombosis of the lower limbs.

Conclusion: PE is a recurrent cause of death in intra-hospital and out-of-hospital patients despite the existing diagnostic, pharmacological and non-pharmacological methods for its prevention. Carrying out a greater number of clinical autopsies will reveal the true impact of this complication in our environment and improve the quality of patient care.