Undiagnosed Diseases in an Aging Population: Pulmonary Embolism and Bronchopneumonia

Important subgroups of the older population are in settings in which cause of death is difficult to ascertain. An autopsy series of an elderly, chronically ill, institutionalized population indicates a 22.8% death rate due primarily to bronchopneumonia, with 20% of diagnoses missed, and 6.4% due to pulmonary embolism, with 50% missed. In a similar age group dying in the hospitals of New York, death rates ascribed to bronchopneumonia were 8.0%, and 2.0% to pulmonary embolism. Present methods of mortality coding would also reduce reporting of the true extent of these two causes of death.