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April 1979

The Impact of Prophylactic Measures on Fatal Pulmonary Embolism

Author Affiliations

From the Department of Surgery, UCLA School of Medicine, Los Angeles (Dr Atik), and the Department of Surgery and Clinical Laboratory, Veterans Administration Hospital, Louisville (Dr Broghamer).

Arch Surg. 1979;114(4):366-369. doi:10.1001/archsurg.1979.01370280020003

• Prompted by reviews showing no significant reduction in the overall incidence of fatal pulmonary embolism in recent years, we examined the incidence of this complication found on autopsy over the 15-year period between 1960 and 1974 in a Veterans Administration Hospital. During the first six years, when no specific prophylactic measures were practiced, 41 patients died of pulmonary embolism on the surgical service; whereas in the last nine years, when dextrans were used prophylactically in high-risk patients, 24 patients had fatal pulmonary embolisms. Of these 24 patients, 21 did not receive the recommended dosages of dextran. There were no significant differences in the average annual number of admissions and major operations, or in the rate of autopsy, between the two periods. We conclude that the prophylactic use of dextran in high-risk surgical patients is a practical, effective, and safe method to reduce the overall mortality from pulmonary embolism.

(Arch Surg 114:366-369, 1979)

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