Will embolism kill a person

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Title:Cause of death pulmonary embolismOther titles:Cause of death embolism of the lungLanguage:GermanAuthor:Thesenfitz, SabineTags:Section protocols; Forensic medicine; protocol of autopsyGND keywords:Pulmonary embolismPublication date:2008Day of the oral exam:2008-07-07Summary:
Within the scope of the present work, 537 sections were evaluated, which were carried out between 1993 and 2004 in the Institute for Forensic Medicine of the University of Hamburg with the label "Death by pulmonary embolism". The average age of the deceased was 65 years. Of the 537 deceased, 427 pathological-anatomical pulmonary embolism was found
be proven as the cause of death. There were 189 men (44%) and 238 women (56%). Women were significantly older than men at the time of death (68 years vs. 63 years).
In the comparative study by Lignitz (1992), 303 pulmonary embolisms were found among 10,963 sections in Hamburg for the period 1983-1992. Our own study showed that between 1993 and 2004 out of a total of 13,492 sections, 427 pulmonary embolisms (3.15%) were morphologically confirmed.
This means a slight increase in pulmonary embolism by almost half a percentage point. Our own study showed that being overweight played a major role in thromboembolism. About a quarter of those who died were obese. As in the last 30 years in developed countries the
The prevalence of obesity has risen sharply and obesity is associated with increased risks for numerous diseases, this in turn could be one of the reasons that the pulmonary embolism death rate has increased
is. Another reason could be the increase in Hamburg's population over the past 12 years, especially the increase in older people. Hypertension was also an important risk factor for pulmonary embolism in one's own
Study. About every 7th patient was affected by it. About every 10th patient was immobile and every 13th patient suffered from pancreatic disease or right heart failure. Nicotine abuse, tumor diseases, pregnancy, cor pulmonale and contraceptives only played a subordinate role as risk factors. The most common morphological findings were chronic right heart failure and wall thickening of the right
Ventricle present. Chronic left heart failure, tumor diseases and cor pulmonale were rare. The risk factors and accompanying findings determined here were largely confirmed in the literature. If pulmonary embolism affects young people, rare specific risk factors should be sought. One case from the autopsy material at hand concerned a young, 17-year-old woman with factor V disease. This is the most common hereditary risk factor for venous thrombosis in Europe. Affected patients are especially at
Combinations with other risk factors (contraceptives, smoking, prolonged immobilization) are at great risk.
93.1% of the deceased had a massive embolism, 1% only a peripheral embolism and 6% a combined embolism. The origin of two-thirds of all thrombi that led to death from pulmonary embolism in the present study were thigh or lower leg veins.
With an adequately operated thrombosis prophylaxis could
further reduce the thromboembolic death rate. This applies in particular to major orthopedic interventions (e.g. hip replacement surgery). In this study, 46 patients had died after hip replacement surgery, although there may have been a gap in thrombosis prophylaxis for these patients when transitioning from the hospital to the home environment.
A total of 185 pulmonary embolisms were confirmed pathological-anatomically in 91% (169 cases) according to death certificates. In the case of 64 deceased, other causes of death were given in the death certificate, although the cause of death was one
Pulmonary embolism turned out. So 39.5% of pulmonary embolisms were recognized clinically correctly, 10.5% were recognized as false-positive. Half of pulmonary embolisms
had not been clinically identified because no information on the cause of death was available on the death certificate. This shows that even today the autopsy is of great importance, especially in the case of causes of death that are difficult to diagnose, such as pulmonary embolism.
Url:https://ediss.sub.uni-hamburg.de/handle/ediss/2199URN:urn: nbn: de: gbv: 18-37662Document type:dissertationSupervisor:PĆ¼schel, Klaus (Prof. Dr.)Included in the collections:Electronic dissertations and habilitations