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Prevalence and risk factors for pulmonary embolism in patients with suspected acute exacerbation of COPD: a multi-center study.

      Highlights

      • PE prevalence in acute exacerbations of chronic obstructive pulmonary disease is highly variable
      • COPD is considered an independent risk factor for pulmonary embolism, doubling the risk of VTE
      • The prevalence of pulmonary embolism in our population with acute exacerbation of COPD and suspected PE was 12.66%
      • Age, female gender, signs and symptoms suggestive of deep vein thrombosis, hypertension, PaCO2 ≤ 40 mmHg, and normal chest-x-ray were significantly associated with a higher PE prevalence
      • In-hospital mortality and mean length of hospitalization were slightly but not significantly higher in patients with PE

      Abstract

      Introduction

      : Pulmonary embolism (PE) prevalence in acute exacerbations of COPD is highly variable.

      Methods

      : To investigate the prevalence and risk factors of PE in patients hospitalized in Departments of Internal Medicine because of AECOPD and suspected PE we conducted a retrospective multicenter study in patients with an AECOPD undergoing chest angio-computed tomography (angio-CT) because of clinical suspect of PE.

      Results

      1043 patients (mean age 75.8 years ± 9.7 years, 34.5 % women) were included; 132 patients had PE (mean prevalence 12.66%, 95% confidence interval 10.73, 14.77%).) confirmed by angio-CT and 54 patients died during hospitalization (5.18 %). At multivariate analysis, age, female gender, clinical signs and symptoms suggestive of deep vein thrombosis, hypertension, PaCO2 ≤ 40 mmHg, and normal chest-x-ray were significantly associated with a higher PE prevalence. Prevalence of PE in patients with 0, 1, 2, 3 or ≥4 risk factors progressively increase from 1.76 to 30.43%. Mean length of hospitalization (LOH) (15.7 vs 14.2 days, p 0.07) and in-hospital mortality (6.1% vs 5.1%, P=0.62) were slightly but not significantly higher in in patients with PE (6.1% vs 5.1%, P=0.62).

      Conclusions

      : PE prevalence is not negligible in this setting. A number of risk factors may help clinicians in identification of patients at increased risk of PE.
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