Incidence of silent postoperative pulmonary emboli in geriatric patients.

Abstract

Abstract:In an attempt to ascertain the incidence of post‐operative pulmonary emboli (including early small emboli) in the elderly, 50 surgical patients (age range, 21–91) were studied both preoperatively and postoperatively by means of the following: lung scintiscanning (four views), electrocardiograms, chest roentgenograms, and determinations of serum glutamic oxalacetic transaminase (SGOT), lactic dehydrogenase (LDH), and bilirubin. These tests were performed twice postoperatively at one‐week and two‐week intervals.In 4 cases the postoperative lung scan findings were compatible with recent pulmonary emboli, although the patients were asymptomatic. There was no consistent correlation with serum enzyme elevations, nor with the sex of the patient, type of operation, type of anesthesia, or diabetic status. All 4 patients with indications of postoperative emboli were over 40 years of age, and 3 of them had undergone their operations in the lithotomy position. The overall incidence of positive findings with postoperative lung scanning was 8 per cent, but in patients over 40 years of age it was 10 per cent.In view of the significant incidence of postoperative pulmonary emboli and the possible age correlation, further study is needed to ascertain the feasibility of prophylactic postoperative anticoagulation therapy in elderly patients.