W Indian Med J
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To investigate the present status of pulmonary embolism as the cause of death in a general hospital population, the author reviewed 610 autopsy reports, and associated hospital records for the period 1985-1989. Pulmonary embolism was the major contributing factor to the cause of death in 61 (10%) of the 610 autopsies performed. ⋯ Fifty-six (92%) of patients dying from pulmonary embolism were of African descent while 5 (8%) were of East Indian descent. Without autopsies. 49 (80.3%) patients dying of pulmonary embolism would have been incorrectly certified and registered in death statistics based on clinical certification only.
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This study represents a review of 33 patients seen at the Kingston Public Hospital, Jamaica, with penetrating cardiac injuries over a 7-year period from 1982 to 1989. Male patients between the ages of 12 and 30 years accounted for more than 80 per cent of cases. A history of syncope associated with haemodynamic instability were the predominant clinical features on presentation. ⋯ Pericardiocentesis was not helpful in making the diagnosis and was only performed as a resuscitative measure in unstable patients prior to thoracotomy. Cardiorrhaphy was performed in the majority of patients through a left anterior lateral thoracotomy with median sternotomy being used only for suspected hilar injuries. A high index of suspicion in patients with penetrating thoracic trauma with expeditious thoracotomy will result in the greatest salvage rate.