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Clinical Trial
. 2023 May 18:18:907-917.
doi: 10.2147/COPD.S410954. eCollection 2023.

Prevalence, Risk Factor and Clinical Characteristics of Venous Thrombus Embolism in Patients with Acute Exacerbation of COPD: A Prospective Multicenter Study

Xia Liu #  1   2 , Xiaojing Jiao #  1 , Xiaowei Gong  3 , Qingrong Nie  4 , Yang Li  2 , Guohua Zhen  5 , Mengyu Cheng  6 , Jianguo He  7 , Yadong Yuan  3 , Yuanhua Yang  1
Affiliations
Clinical Trial

Prevalence, Risk Factor and Clinical Characteristics of Venous Thrombus Embolism in Patients with Acute Exacerbation of COPD: A Prospective Multicenter Study

Xia Liu et al. Int J Chron Obstruct Pulmon Dis. .

Abstract

Background and objective: The prevalence of venous thrombus embolism (VTE) in patients with chronic obstructive pulmonary disease (COPD) is higher than in patients without COPD. Owing to the similarity of clinical symptoms between PE and acute exacerbation COPD (AECOPD), PE is likely to be overlooked or underdiagnosed in patients with AECOPD. The aim of the study was to investigate the prevalence, risk factor, clinical characteristics, and prognostic impact of VTE in patients with AECOPD.

Methods: This multicenter, prospective, cohort study was conducted in 11 research centers of China. Data on the baseline characteristics, VTE-related risk factors, clinical symptoms, laboratory examination results, computed tomography pulmonary angiography (CTPA) and lower limb venous ultrasound of AECOPD patients were collected. Patients were followed up for 1 year.

Results: A total of 1580 AECOPD patients were included in the study. The mean (SD) age was 70.4 (9.9) years and 195 (26%) patients were women. The prevalence of VTE was 24.5% (387/1580) and PE was 16.8% (266/1580). VTE patients were older; had higher BMI; and longer course of COPD than non-VTE patients. The history of VTE, cor pulmonale, less purulent sputum, increased respiratory rate, higher D-dimer, and higher NT-proBNP/BNP were independently associated with VTE in hospitalized patients with AECOPD. The mortality at 1-year was higher in patients with VTE than patients without VTE (12.9% vs 4.5%, p<0.01). There was no significant difference in the prognosis of patients with PE in segmental or subsegmental arteries and in main pulmonary arteries or lobar arteries (P>0.05).

Conclusion: VTE is common in COPD patients and is associated with poor prognosis. Patients with PE at different locations had poorer prognosis than patients without PE. It is necessary to perform active screening strategy for VTE in AECOPD patients with risk factors.

Keywords: chronic obstructive pulmonary disease; computed tomography pulmonary angiography; prognosis; venous thromboembolism.

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Conflict of interest statement

The author(s) declare no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1
Figure 1
Flowchart of patients hospitalized with AECOPD.
Figure 2
Figure 2
Kaplan–Meier curves showing the mortality rates in chronic obstructive pulmonary disease patients with PE, with DVT-only and without VTE.
Figure 3
Figure 3
Kaplan–Meier curves showing the mortality rates in chronic obstructive pulmonary disease patients with PE of main pulmonary artery or lobar artery, with PE of segmental or subsegmental artery and without PE.
See this image and copyright information in PMC

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