Chest
Special FeaturePrevalence of Pulmonary Embolism in Acute Exacerbations of COPD: A Systematic Review and Metaanalysis
Section snippets
Data Searches and Study Selection
A comprehensive literature search for English and French articles was conducted using MEDLINE (1949-April 2008), CINAHL (1982-April 2008), and EMBASE (1980-April 2008). Search terms for VTE, which included “pulmonary embolism,” “PE,” “thromboembolism,” or “venous thromboembolism” were combined with those for COPD, which included “COPD,” “COPD exacerbation,” “emphysema,” and “bronchitis.” This process was complemented by hand searching of bibliographies of retrieved articles to find additional
Study Selection
A total of 2,407 articles were identified using the MEDLINE, CINAHL, and Embase search engines; 2,384 articles were excluded because they did not meet the inclusion criteria or were multiple articles from the same cohort. The remaining 23 articles were retrieved for detailed examination. Of these, 11 articles were excluded for the following reasons on further review: (1) they contained a significant selection bias for VTE; (2) they did not employ CT scanning or pulmonary angiography in their
Discussion
The most important finding of our study was the relatively high prevalence of PE among patients who required hospitalization for acute exacerbations of COPD. Overall, one of four COPD patients who were hospitalized and investigated for VTE had objective evidence for PE requiring anticoagulant therapy. While striking, these data should be interpreted cautiously owing to the heterogeneity in the design, the setting, and enrollment criteria among the included studies.
Because symptoms of PE may be
Acknowledgment
The authors wish to thank the three anonymous reviewers whose comments enhanced the quality of this article.
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Cited by (247)
Respiratory Comorbidity and Pulmonary Embolism
2023, Archivos de BronconeumologiaTowards the elimination of chronic obstructive pulmonary disease: a Lancet Commission
2022, The LancetCitation Excerpt :However, there are no clear standardised recommendations for how to exclude these conditions in guidelines, and misdiagnosis of an exacerbation at the time of increased respiratory symptoms can lead to ineffective treatment. For example, the estimated prevalence of pulmonary embolism in patients with COPD who report worsening symptoms of dyspnoea is as high as 20%.208 In addition, patients with COPD can experience late detection of a cardiac event, even though 25% present with increased troponin concentrations indicative of myocardial injury.209
Pulmonary embolism with chronic obstructive pulmonary disease
2021, Chronic Diseases and Translational MedicineCitation Excerpt :PE is an important cause of COPD deterioration in nearly 25% of hospitalized patients. If COPD is not controlled, the incidence rate of patients with PE will increase significantly, and the mortality will be almost double.53 For the treatment of high-risk PE with hemodynamic instability in the acute phase, it is recommended to immediately use unfractionated heparin (UFH) anticoagulation, including intravenous administration and systemic thrombolysis.
Thrombelastography and Conventional Coagulation Markers in Chronic Obstructive Pulmonary Disease: A Prospective Paired-Measurements Study Comparing Exacerbation and Stable Phases
2024, International Journal of Molecular Sciences
This project was supported by the Canadian Institutes of Health Research and the Michael Smith Foundation for Health Research.
None of the authors have any conflicts of interest to disclose.
Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/misc/reprints.shtml).
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Dr. Sin is a Canada Research Chair in COPD and a senior scholar with the Michael Smith Foundation for Health Research.