CIRCADIAN PATTERN OF POSTSURGICAL FATAL PULMONARY-EMBOLISM

Background: The circadian distribution of fatal pulmonary thromboembol ism in general surgical patients is unknown. Patients and methods: One hundred consecutive cases of pulmonary embolism, with reliable clinic al notes and data, were studied (67 men and 33 women; mean age 71 year s). Only post-surgical cases were considered in this analysis. Patient s had undergone elective (78%) or emergency abdominal surgery (22%). C orrect prophylaxis (according to the Windsor Consensus Statement) had been. used in 12%. Cases were grouped according to the time of onset o f signs and symptoms related to pulmonary embolism at one hour interva ls. Results: The maximum incidence of fatal pulmonary embolism was bet ween 7.00 a.m. and 1.00 p.m. with the highest peaks at 9.00 and 11.00 a.m. 9% of deaths) (P < 0.02). When results from this study were compa red to a previous study no significant difference was observed between the distribution profile of cases from general medical wards and surg ical wards. Conclusion: It appears that in surgical patients there is a circadian pattern in pulmonary embolism as already documented in med ical patients.