Chen Wei-Ji, Lin Che-Chen, Lin Chang-Yi, Chang Yen-Jung, Sung Fung-Chang, Kao Chia-Hung, Yeh Jun-Jun
1From the Chest Division, Department of Internal Medicine, Mackay Memorial Hospital , Taipei , Taiwan.
COPD. 2014 Aug;11(4):438-43. doi: 10.3109/15412555.2013.813927.
To evaluate the incidence of pulmonary embolism (PE) in patients with chronic obstructive pulmonary disease (COPD) in Taiwan.
This was a retrospective population-based cohort study using data retrieved from Taiwan's National Health Insurance Research Database (2000 to 2008), which contains 99% of Taiwanese healthcare data. The evaluations included 355,878 COPD patients and 355,878 non-COPD patients for comparison.
The incidence of PE in the COPD cohort was 12.31 per 10,000 person-years (1.37/10,000 persons/y), which was approximately 4-times higher than in the comparison cohort (0.35/10,000 persons/y). In the COPD cohort, risk of PE was higher in the young age group (20-59 y, HR 4.64, 95% CI 3.06-7.03) than in other age groups. Risk of PE was higher in patients with COPD combined with hypertension, coronary artery disease, and cancer, or those with previous operation (HR 4.16, 4.75, 4.56, and 4.50 respectively) than in those with COPD and no comorbidity.
The overall incidence of PE is lower in Taiwan than in western countries. However, the prevalence of PE in COPD patients is higher than in non-COPD patients and increases with age. It is crucial to incorporate PE into the differential diagnosis of COPD exacerbation for clinical physicians.
评估台湾慢性阻塞性肺疾病（COPD）患者肺栓塞（PE）的发生率。
这是一项基于人群的回顾性队列研究，使用从台湾国民健康保险研究数据库（2000年至2008年）检索的数据，该数据库包含99%的台湾医疗数据。评估纳入了355,878例COPD患者和355,878例非COPD患者进行比较。
COPD队列中PE的发生率为每10,000人年12.31例（1.37/10,000人/年），约为比较队列（0.35/10,000人/年）的4倍。在COPD队列中，年轻年龄组（20 - 59岁，HR 4.64，95% CI 3.06 - 7.03）的PE风险高于其他年龄组。合并高血压、冠状动脉疾病和癌症的COPD患者或有既往手术史的患者发生PE的风险（分别为HR 4.16、4.75、4.56和4.50）高于无合并症的COPD患者。
台湾PE的总体发生率低于西方国家。然而，COPD患者中PE的患病率高于非COPD患者，且随年龄增加。对于临床医生而言，将PE纳入COPD加重的鉴别诊断至关重要。
