TY - JOUR
T1 - Prevalence and risk factors for pulmonary embolism in patients with suspected acute exacerbation of COPD
T2 - a multi-center study
AU - Young-FADOI Study Group
AU - Dentali, Francesco
AU - Pomero, Fulvio
AU - Micco, Pierpaolo Di
AU - La Regina, Micaela
AU - Landini, Federica
AU - Mumoli, Nicola
AU - Pieralli, Filippo
AU - Giorgi-Pierfranceschi, Matteo
AU - Re, Roberta
AU - Vitale, Josè
AU - Fabbri, Leonardo M
AU - Fontanella, Andrea
AU - Arioli, Dimitriy
N1 - Copyright © 2020 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
PY - 2020/10
Y1 - 2020/10
N2 - 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.
AB - 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.
U2 - 10.1016/j.ejim.2020.05.006
DO - 10.1016/j.ejim.2020.05.006
M3 - Article
C2 - 32474052
SN - 0953-6205
VL - 80
SP - 54
EP - 59
JO - European Journal of Internal Medicine
JF - European Journal of Internal Medicine
ER -