Chronic Obstructive Pulmonary Disease in Patients With Acute Symptomatic Pulmonary Embolism

Fernández, Carolina; Jiménez, David; Miguel, Javier de; Martí, David; Díaz, Gema; Sueiro, Antonio

doi:10.1016/s1579-2129(09)72419-x

Cited by 14 publications

(6 citation statements)

References 28 publications

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“…However, various studies have shown that patients of COPD with PE had lower pretest probability for PE using various PE predicting scores. [ 22 30 31 ] These observations showed that the use of clinical prediction scoring system can be misleading when used in patients of COPD in predicting PE.…”

Section: Discussionmentioning

confidence: 99%

Prevalence and predictors of pulmonary embolism in patients with acute exacerbation of chronic obstructive pulmonary disease

et al. 2021

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Background: The prevalence of pulmonary embolism (PE) in patients of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) varies over a wide range. Early detection and treatment of PE in AECOPD is a key to improve patient outcome. The purpose of the study was to investigate the prevalence and predictors of PE in patients of AECOPD in a high burden region of North India. Materials and Methods: This prospective study included patients of AECOPD with no obvious cause of exacerbation on initial evaluation. Apart from routine workup, the participants underwent assessment of D-dimer, compression ultrasound and venous Doppler ultrasound of the lower limbs and pelvic veins, and a multidetector computed tomography pulmonary angiography. Results: A total of 100 patients of AECOPD with unknown etiology were included. PE as a possible cause of AE-COPD was observed in 14% of patients. Among the participants with PE, 63% ( n = 9) had a concomitant presence of lower extremity deep venous thrombosis. Hemoptysis and chest pain were significantly higher in patients of AECOPD with PE ([35.7% vs. 7%, P = 0.002] and [92.9% vs. 38.4%, P = 0.001]). Likelihood of PE was significantly higher in patients who presented with tachycardia, tachypnea, respiratory alkalosis (PaCO2 <45 mmHg and pH >7.45), and hypotension. No difference was observed between the two groups in terms of in-hospital mortality, age, sex distribution, and risk factors for embolism except for the previous history of venous thromboembolism (35.7% vs. 12.8% P = 0.03). Conclusion: PE was probably responsible for AECOPD in 14% of patients with no obvious cause on initial assessment. Patients who present with chest pain, hemoptysis, tachypnea, tachycardia, and respiratory alkalosis should be particularly screened for PE.

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Section: Discussionmentioning

confidence: 99%

Prevalence and predictors of pulmonary embolism in patients with acute exacerbation of chronic obstructive pulmonary disease

et al. 2021

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“…Previous studies on usage of clinical scoring systems and D-dimer levels during exacerbation have contradictory results. When we look at studies with Wells scoring system, since it can be used in both inpatient and outpatient care, Fernandez et al reported a lower pretest probability in patients who had PE and COPD than patients who had PE without COPD (12). Akpınar et al found a Wells score of lower pretest probability in 24% of patients diagnosed as PE during exacerbation (10).…”

Section: Discussionmentioning

confidence: 99%

“…This may lead to delayed diagnosis of PE and even may cause higher mortality if the diagnosis is missed. In patients with PE, COPD was shown to delay diagnosis more than 3 days (12). PE presence is reported to increase mortality 1.5 times in COPD patients who were admitted to emergency room with exacerbation (13).…”

Section: Introductionmentioning

confidence: 99%

Impact of Pulmonary Embolism on Acute Chronic Obstructive Pulmonary Disease Exacerbation

Türk

Yıldırım

Sevimli

et al. 2017

GMJ

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Purpose: This study aims to assess effect of pulmonary embolism (PE) on clinical and laboratory parameters of patients hospitalized for acute exacerbations of chronic obstructive pulmonary disease (AECOPD). Risk factors for PE development were also evaluated. Methods: In this retrospective study, patients who were hospitalized for AECOPD and underwent computed tomographic pulmonary angiography scan (CTPA) between 2009 and 2011 were included. Patients with PE were evaluated separately as those diagnosed at initial examination and those suspected during exacerbation therapy since they had inadequate response. Binary logistic regression analysis was used in order to determine risk factors on PE development. Results: The study consisted of 36 patients, 13 patients (36.1%) had PE. FEV1 and FEV1/FVC values were higher in PE group (53.7% vs 41.4%; 62.3% vs 52% respectively; p<0.05). There was no difference between D-dimer levels of PE and non-PE patients. Risk of PE development did not differ with analyzed variables. Those diagnosed at initial examination had significantly less number of exacerbations in the last one year than those diagnosed during therapy (1.1 vs 3.2; p<0.05). Conclusion: PE should always be considered in AECOPD etiology, particularly in patients with frequent exacerbation history and D-dimer levels may be misleading.

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“…COPD patients also tend to have coexisting coronary artery disease and congestive heart failure, with inherent increased risk of pulmonary edema. Finally, they display an increased propensity for fatal pulmonary embolism [137][138][139][140][141].…”

Section: Postoperative Pulmonary Complications In Multimorbid Patientsmentioning

confidence: 99%

Multimorbidity and Critical Care Neurosurgery: Minimizing Major Perioperative Cardiopulmonary Complications

Algahtani

Merenda

2020

Neurocrit Care

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With increasing prevalence of chronic diseases, multimorbid patients have become commonplace in the neurosurgical intensive care unit (neuro-ICU), offering unique management challenges. By reducing physiological reserve and interacting with one another, chronic comorbidities pose a greatly enhanced risk of major postoperative medical complications, especially cardiopulmonary complications, which ultimately exert a negative impact on neurosurgical outcomes. These premises underscore the importance of perioperative optimization, in turn requiring a thorough preoperative risk stratification, a basic understanding of a multimorbid patient's deranged physiology and a proper appreciation of the potential of surgery, anesthesia and neurocritical care interventions to exacerbate comorbid pathophysiologies. This knowledge enables neurosurgeons, neuroanesthesiologists and neurointensivists to function with a heightened level of vigilance in the care of these high-risk patients and can inform the perioperative neuro-ICU management with individualized strategies able to minimize the risk of untoward outcomes. This review highlights potential pitfalls in the intra-and postoperative neuro-ICU period, describes common preoperative risk stratification tools and discusses tailored perioperative ICU management strategies in multimorbid neurosurgical patients, with a special focus on approaches geared toward the minimization of postoperative cardiopulmonary complications and unplanned reintubation.

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Chronic Obstructive Pulmonary Disease in Patients With Acute Symptomatic Pulmonary Embolism

Cited by 14 publications

References 28 publications

Prevalence and predictors of pulmonary embolism in patients with acute exacerbation of chronic obstructive pulmonary disease

Prevalence and predictors of pulmonary embolism in patients with acute exacerbation of chronic obstructive pulmonary disease

Impact of Pulmonary Embolism on Acute Chronic Obstructive Pulmonary Disease Exacerbation

Multimorbidity and Critical Care Neurosurgery: Minimizing Major Perioperative Cardiopulmonary Complications

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