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The effect of COPD on the incidence and mortality of hospitalized patients with pulmonary embolism: A nationwide population-based study (2016-2018)

Published:November 26, 2020DOI:https://doi.org/10.1016/j.ejim.2020.11.009

      Highlights

      • Adjusted incidence of hospitalizations for PE was higher in COPD patients.
      • In hospital mortality (IHM) was significantly associated with suffering COPD.
      • IHM predictors included age, comorbidity, atrial fibrillation and oxygen dependence
      • Obesity was associated with lower IHM in COPD patients hospitalized with PE.

      Abstract

      Background

      To examine the incidence, clinical characteristics, and in-hospital outcomes of pulmonary embolism (PE) among hospitalized patients with or without chronic obstructive pulmonary disease (COPD) in Spain, and to identify predictors of in-hospital-mortality (IHM) after PE among patients with and without COPD.

      Methods

      We included all patients aged ≥ 40 years who were hospitalised for PE between 2016 and 2018. Data were collected from the Spanish National Hospital Discharge Database.

      Results

      We identified 47,190 hospitalizations for PE during the study period, 7.49% with COPD. Adjusted incidence of PE was higher in COPD patients than in those without COPD (IRR 1.16; 95%CI 1.13-1.19). Crude IHM was significantly higher in PE hospitalized patients with COPD than in those without COPD (9.86% vs 3.59%; p<0.001). Predictor factors of IHM in COPD patients with PE included older age, higher Charlson comorbidity index, atrial fibrillation, massive PE and dependence on oxygen prior to hospital admission. However, obesity was associated with lower IHM. For PE hospitalized patients, suffering COPD increased the probability of dying in the hospital (adjusted OR 2.84; 95%CI 2.27-3.55).

      Conclusions

      Our results revealed that incidence of PE was higher in COPD patients than in those without COPD. Furthermore, COPD was a risk factor for IHM after PE.

      Keywords

      Abbreviations:

      BMI (body mass index), CCI (Charlson comorbidity index), CI (confidence intervals), COPD (chronic obstructive pulmonary disease), DRG (diagnosis-related groups), ICD-10 (international classification of diseases-10th revision), IHM (in-hospital-mortality), IRR (incidence rate ratios), LOHS (length of hospital stay), OR (odds ratio), PE (pulmonary embolism), PSM (propensity score matching), SNHDD (Spanish national hospital discharge database)
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