RESUMO
BACKGROUND: The circadian distribution of fatal pulmonary thromboembolism in general surgical patients is unknown. PATIENTS AND METHODS: One hundred consecutive cases of pulmonary embolism, with reliable clinical notes and data, were studied (67 men and 33 women; mean age 71 years). Only post-surgical cases were considered in this analysis. Patients had undergone elective (78%) or emergency abdominal surgery (22%). Correct prophylaxis (according to the Windsor Consensus Statement) had been used in 12%. Cases were grouped according to the time of onset of signs and symptoms related to pulmonary embolism at one hour intervals. RESULTS: The maximum incidence of fatal pulmonary embolism was between 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 compared to a previous study no significant difference was observed between the distribution profile of cases from general medical wards and surgical wards. CONCLUSION: It appears that in surgical patients there is a circadian pattern in pulmonary embolism as already documented in medical patients.