Fatal pulmonary embolism after total hip arthroplasty: Diurnal variations

From 1970 through 1986, a total of 18,104 Charnley low-friction arthroplast ies were performed; of these, 122 deaths occurred from pulmonary embolism w ithin 1 year of surgery. Diagnosis was confirmed by postmortem examination in 71% of cases. The exact time of the onset of the complication was record ed in 90 cases. In 74 (82%) cases, the time of collapse occurred during the 7-hour period from 9:00 AM to 4:00 PM, and in 16(18%) cases, it occurred i n the 17-hour period from 4:00 PM to 9:00 AM. The patient's activity at the time of collapse was recorded in 73 cases. Sixty (82%) were mobile, 3 were in the bathroom, and 10(14%) were in bed. Sixty-six (70.2%) patients died within 1 hour of the onset of symptoms.