Fatal pulmonary thromboembolism: deep vein thrombosis incidence at coronial autopsy

Abstract

Most pulmonary thromboemboli arise from deep vein thrombosis of the lower legs.1 When pulmonary thromboembolism is identified as the cause of death at autopsy, it has been recommended that the calves should be dissected to locate the source of the embolus.2,3 However, it is uncertain how often deep vein thrombosis will be found and if the incidence is altered by risk factors for pulmonary thromboembolism. This research aimed to determine how often deep vein thrombosis of the lower legs was found at Coronial autopsy when death had resulted from pulmonary thromboembolism, and to ascertain if risk factors affect the likelihood of finding deep vein thrombosis. Autopsy reports of pulmonary thromboembolism deaths in the year 2016 were identified on the National Coronial Information System. Dissection information and risk factors for pulmonary thromboembolism were recorded. Risk factors were analysed by logistic regression to determine if there was predictive value on the probability of finding deep vein thrombosis. A total of 235 pulmonary thromboembolism fatalities were identified. Deep vein thrombosis was found in 76.6% full-body autopsies. A recent hospital admission was found to have a statistically significant positive influence (p=0.01) on finding deep vein thrombosis of the lower legs.