Comparison of Clinical Characteristics and Outcomes of Patients with COPD Exacerbation with or without Venous Thromboembolism

Abstract

Background: Although some studies evaluated venous thromboembolism (VTE) prevalence in patients with chronic obstructive pulmonary disease (COPD), they contain no detailed description of the patients’ characteristics. Objectives: It was the aim of this study to investigate the frequency and clinical characteristics and outcomes of VTE in patients with COPD exacerbation. Methods: Between October 2004 and February 2005, 120 consecutive patients were included in the study. On admission, Doppler examination of lower extremities in all cases and spiral computed tomography of the thorax in cases with a suspicion of pulmonary thromboembolism were performed. A questionnaire was used to take a detailed history. In addition to routine laboratory tests, chest X-ray, postbronchodilator spirometry, arterial blood gas analysis and serum levels of D-dimer and C-reactive protein were evaluated, as well as dyspnea score and performance status before exacerbation. The hospitalization durations and mechanical ventilation requirements were also recorded. Results: VTE was determined in 16 cases (13.3%). In patients with VTE, the travel history was higher (p < 0.001), the dyspnea score worse (p = 0.005), the duration of hospitalization longer (p < 0.001) and the mechanical ventilation requirement increased (p < 0.001); a change in mental status was highly associated with the presence of VTE (p < 0.001). Conclusions: It seems that VTE occurrence was higher in the presence of a risk factor causing immobility such as travel history and increased dyspnea. The cases with severe disease are more likely to have VTE. Preventive measures may be considered in such patients because their hospitalization stay and mechanical ventilation requirement are increased.

Relationship of Metabolic Alkalosis, Azotemia and Morbidity in Patients with Chronic Obstructive Pulmonary Disease and Hypercapnia

“…Patients received controlled oxygen therapy via nasal cannula, and antibiotic agents, histamine-2 receptor blockers, bronchodilators and/or steroids were administered. Several previous studies have reported that patients with severe COPD are more likely to have venous thromboembolism [13]; therefore, we routinely used subcutaneous low-molecular-weight heparin in all patients.…”

Risk Factors for Venous Thromboembolism in Chronic Obstructive Pulmonary Disease

“…14 Our study identified a small cohort of participants (5.7%) with VTE, which is consistent with some studies with similar prevalence rates. 5,15,16 It should be noted that most studies have examined the prevalence of VTE in the setting of an acute exacerbation, but our cohort reported history of VTE irrespective of exacerbations.…”

“…2,3 One study found PE diagnosed by computed tomography (CT) angiography in 25% of individuals presenting with an unknown etiology for a COPD exacerbation. 4 Overall, the reported prevalence of VTE during COPD exacerbations ranges from 5%–29% 5–8 …”

“…9 Another showed increased duration of hospitalization and need for mechanical ventilation. 5 Based on current data, it is unclear what COPD risk factors or clinical characteristics places patients at increased VTE risk. We performed an epidemiological analysis of the COPD Genetic Epidemiology (COPDGene) study in an effort to characterize COPD individuals with a history of VTE.…”

Real-life use of thromboprophylaxis in patients hospitalized for pulmonary disorders: A single-center retrospective study

“…For example, the risk of VTE in chronic obstructive pulmonary disease (COPD) exacerbation ranges from 5% to even 29%. [15][16][17][18] Postmortem examination of patients who died due to COPD exacerbation have demonstrated pulmonary embolism (PE) in 28-51% of cases. 19,20 Lung cancer is a well-established potent risk factor for developing VTE.…”