THROMBOEMBOLISM AS A CAUSE OF SUDDEN DEATH IN IMMOBILIZED MEDICAL PATIENTS
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Keywords
Pulmonary embolism, immobilization, deep vein thrombosis, clinicopathological correlation, venous anatomy
Abstract
Background: Pulmonary embolism is a major cause of sudden clinical deterioration in immobilized medical patients and frequently remains unrecognized due to nonspecific presentation. Understanding the clinical predictors and anatomical pathway of thromboembolism is essential for early diagnosis and prevention.
Objective: To evaluate the clinical risk factors, warning signs, and anatomical distribution of pulmonary embolism in immobilized patients using clinicopathological correlation.
Methodology: This retrospective clinicopathological study was conducted at Sir Syed College of Medical Sciences (for Girls) & Khairpur Medical College, Khairpur Mir’s from March 2024 to April 2025 and included 72 immobilized medical patients. Clinical records were reviewed for demographic characteristics, duration of immobilization, comorbidities, thromboprophylaxis, clinical presentation, and laboratory parameters. Postmortem examination was used for anatomical confirmation of thrombus origin and pulmonary arterial involvement. Statistical analysis was performed using chi-square and independent t-tests with p ≤ 0.05 considered significant.
Results: Pulmonary embolism was confirmed in 48 patients (66.7%). Prolonged immobilization (>5 days), heart failure, previous deep vein thrombosis, and absence of thromboprophylaxis were significantly associated with embolism (p<0.05). Dyspnea, hypoxia, tachycardia, syncope, and elevated D-dimer were important clinical predictors. The femoral and popliteal veins were the most frequent thrombus sources, while the pulmonary arterial bifurcation was the most common embolic location, often accompanied by acute right ventricular dilatation.
Conclusion: Pulmonary embolism in immobilized patients follows a recognizable clinical and anatomical pattern. Early risk assessment and routine thromboprophylaxis can substantially reduce preventable deterioration and mortality.
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
Rajesh
Associate Professor of Medicine, Sir Syed College of Medical Sciences (for Girls), Karachi, Pakistan
Vinod Kumar
Assistant Professor of Medicine, Sir Syed College of Medical Sciences (for Girls), Karachi, Pakistan
Maryam Sodhro
Demonstrator of Anatomy, Khairpur Medical College, Khairpur Mirs, Pakistan
Zulfiqar Ali Bhatti
Associate Professor of Anatomy, Khairpur Medical College, Khairpur Mir’s, Pakistan
Shabeeta Bai
Assistant Professor of Pediatric Nephrology, Sindh Institute of Child Health and Neonatology, Karachi, Pakistan
