Clinical characteristics of acute pulmonary embolism following surgery

Abstract

Objective To analyze the clinical characteristics, diagnosis, therapy and prognosis of acute pulmonary embolism (APE) following surgery so as to advise clinicians to pay more attention to and prevent postoperative APE. Method Thirty-one APE patients following surgery treated in the recent 8 years were analyzed retrospectively. The clinical features, diagnosis, therapy and prognosis of patients were analyzed. Results (1) Post-operative APE patients accounted for 21.9% of all APR patients during that period. The mortality of patients after surgical operation was 3.2%. (2) APE following surgery often occurred in patients after operations of spine, abdomen, gynecological surgery and point replacement as well as in patients with malignant tumor. The APE following surgery often occurred in the first week after surgery. The APE after surgery for malignant tumor occurred sooner. (3) Among many clinical manifestations, dyspnea (90.3%) was the commonest one. Other manifestations included chest pain, palpitation and syncope. The typical triad of dyspnea, hemoptysis and cheat pain was rarely seen. (4) The venous thrombolysis was a absolute contra-indication for massive PE after surgery. Catheter embolectomy and fragmentation, and surgical embolectomy were the alternative treatment. Conclusions Surgery is the essential risk factor of APE. When patients present dyspnea, chest pain or syncope, clinicians should pay attention to APE. Anticoagulation and embolectomy can improve the prognosais of the patients. Key words: Pulmonary embolism; Surgery; Risk factor