This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (107)  • Contact me when this article is cited  Related Content  • Similar articles in JAMA  Social Bookmarking   What's this?

The Changing Mortality in Hospitalized Patients

S. Edwards Dismuke, MD, MSPH; Edward H. Wagner, MD, MPH

JAMA. 1986;255(15):2039-2042.

Abstract
We studied the frequency and characteristics of death due to pulmonary embolism among all hospital and surgical patients in a university hospital from 1966 through 1980. Of 6,858 deaths, 3,412 autopsies were performed using a standardized and sensitive technique for pulmonary dissection. Our study showed that 6% of deceased patients (4.7% of surgical patients) had massive fatal embolism. Significant declines in embolism mortality were noted during this time period for hospital and surgical patients. The percentage of embolism cases among autopsies fell from 9.3% in the first five years to 3.8% in the last five years. Excluding patients receiving anticoagulants at the time of death, these percentages fell from 8.8% to 2.7% The estimated hospital mortality rate for embolism fell during the same years from 0.37% of hospital discharges to 0.13%. During the years studied, the use of anticoagulants among all adult patients at the hospital increased from 4% of patients to nearly 12.3%. This and other evidence suggest the possibility that both the incidence rate and the case-fatality rate for pulmonary embolism have decreased in the hospital population we studied.

(JAMA 1986;255:2039-2042)

Author Affiliations
From the Robert Wood Johnson Clinical Scholars' Program (Dr Dismuke) and the Departments of Medicine and Epidemiology, University of North Carolina, Chapel Hill (Drs Dismuke and Wagner). Dr Dismuke is now with the Departments of Medicine and Community Medicine, W. F. Bowld Hospital, University of Tennessee Center for the Health Sciences, Memphis. Dr Wagner is now with the Center for Health Studies, Group Health Cooperative of Puget Sound, Seattle.

Footnotes
Reprint requests to Department of Community Medicine, University of Tennessee Center for the Health Sciences, 66 N Pauline, Suite 232, Memphis, TN 38163 (Dr Dismuke).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Recent Trends in Clinical Outcomes and Resource Utilization for Pulmonary Embolism in the United States: Findings From the Nationwide Inpatient Sample
Park et al.
Chest 2009;136:983-990.
ABSTRACT | FULL TEXT  

A decision-tree model to estimate the impact on cost-effectiveness of a venous thromboembolism prophylaxis guideline
Ferrando et al.
Qual Saf Health Care 2009;18:309-313.
ABSTRACT | FULL TEXT  

Computed Tomographic Pulmonary Angiography vs Ventilation-Perfusion Lung Scanning in Patients With Suspected Pulmonary Embolism: A Randomized Controlled Trial
Anderson et al.
JAMA 2007;298:2743-2753.
ABSTRACT | FULL TEXT  

Efficacy of Deep Venous Thrombosis Prophylaxis in the Medical Intensive Care Unit
Khouli et al.
J Intensive Care Med 2006;21:352-358.
ABSTRACT  

Logistic Regression Analysis of Potential Prognostic Factors for Pulmonary Thromboembolism
Yoo et al.
Chest 2003;123:813-821.
ABSTRACT | FULL TEXT  

Current practice of prophylactic anticoagulation in Guillain-Barre syndrome
Gaber et al.
Clin Rehabil 2002;16:190-193.
ABSTRACT  

Prevention of Venous Thromboembolism
Geerts et al.
Chest 2001;119 :132S-175S.
FULL TEXT  

Diagnostic Value of Arterial Blood Gas Measurement in Suspected Pulmonary Embolism
RODGER et al.
Am. J. Respir. Crit. Care Med. 2000;162:2105-2108.
ABSTRACT | FULL TEXT  

Low-Molecular-Weight Heparin vs Heparin in the Treatment of Patients With Pulmonary Embolism
Hull et al.
Arch Intern Med 2000;160:229-236.
ABSTRACT | FULL TEXT  

Emergent Bedside Transesophageal Echocardiography in the Resuscitation of Sudden Cardiac Arrest after Tricuspid Inflow Obstruction and Pulmonary Embolism
Tsai et al.
Anesth. Analg. 1999;89:1406-1406.
FULL TEXT  

Prophylaxis of Deep Vein Thrombosis and Pulmonary Embolism: Current Recommendations
Hull and Pineo
CLIN APPL THROMB HEMOST 1998;4:96-104.
ABSTRACT  

Prevention of Venous Thromboembolism: An Update
Clagett
PERSPECT VASC SURG ENDOVASC THER 1994;7:71-84.
 

Experimental Evaluation of a Retrievable Vena Cava Filter
Nakagawa et al.
VASC ENDOVASCULAR SURG 1994;28:7-14.
ABSTRACT  

Physician Practices in the Prevention of Venous Thromboembolism
Anderson et al.
ANN INTERN MED 1991;115:591-595.
ABSTRACT  

A Population-Based Perspective of the Hospital Incidence and Case-Fatality Rates of Deep Vein Thrombosis and Pulmonary Embolism: The Worcester DVT Study
Anderson et al.
Arch Intern Med 1991;151:933-938.
ABSTRACT  

Mortality From Pulmonary Embolism
Johnson
JAMA 1986;256:867-867.
ABSTRACT