| [Objective] Venous thromboembolism(VTE),which comprized by deep venous thrombosis(DVT) and pulmonary thromboembolism(PTE), has a feature of high morbidity and fatality rate, as well as a high rate of missed diagnosis. Currently, there is a lack of large sample epidemiological data about VTE, especially data from autopsy research. This study aimed to evaluate the prevalence and characteristics of VTE in the the Chinese People’s Liberation Army (PLA) General Hospital over recent years by both pathological and clinical methods, as well as the hospital’s performance of the antemortem prophylaxis, diagnosis, and treatment of VTE.[Methods]① Pathological investigation part: All medical records of deaths from the South Building Department of the Chinese PLA General Hospital were retrospectively reviewed, for the period of January 1, 2006 to December 31, 2015. Cases in which autopsies had been performed were identified and further analyzed. The numbers of patients with PTE were recorded. The medical records of patients with PTE were then subjected to detailed analysis. Details regarding autopsy findings and clinical features were noted. The thrombosis risk of patients with PTE was assessed using the Caprini risk assessment model (2009 edition). Prophylactic measures, as well as diagnosis and treatment of PTE were also recorded if performed. ②Clinical investigation part: All medical records from the Chinese PLA General Hospital were searched, for the period of January 1, 2009 to December 31, 2015. Cases in which VTE had been diagnosed clinically were identified and further verified. Prevalence of VTE was detailedly analyzed. Cases in which PTE occurred during hospitalization were particularly investigated.[Results] Autopsies were performed in 278 of the 1057 (26.3%) patients who died during the study period. Of the patients who underwent autopsy, 9 patients were shown to have PTE (3.2% of all autopsies) and in 7 (2.5% of all autopsies) patients,the PTE was considered to be fatal. Embolisms were found in the trunk and bilateral main branches of the pulmonary artery tree in all 7 fatal PTE cases. Hospital’s antemortem prophylactic rate was 33.3%. None of the 9 patients had received a clinical diagnosis of PTE before death. 4360 cases of VTE were clinically diagnosed during the study period, among which 665 cases were PTE alone; 3322 cases were DVT alone and 373 cases had both PTE and DVT. The prevalence rate of VTE was 4.86‰, while the prevalence rate of PTE and DVT was 1.16‰ and 4.12‰respectively. The prevalence rate of VTE among non-surgical departments was higher than that of surgical departments(5.78‰ vs 3.67‰,P<0.05)。PTE was diagnosed in 2.6% of all dead patients. PTE related fatality rate was 2.4%. 136 cases of PTE occurred during hospitalization, which were more frequently seen in surgical departments than that in non-surgical departments (70 cases vs 66 cases). The fatality rate of in-hospital PTE was 62.5% (85 cases). Most embolisms involved more than 1 pulmonary lobe(73.2%) . Drug prophylactic rate of in-hospital PTE patients was 33.3%.[Conclusion] The prevalence rate of autopsy verified PTE in our study were lower than that reported by western countries. This finding indicates that the effect of race might play an important role in the prevalence of PTE. The fatality rate of in-hospital PTE was extremely high, whereas the prophylactic rate was relatively low. Clinicians should pay more attention to this condition. |
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