Department of Medicine and Surgery, Insubria University, Varese, Italy.
Department of Internal Medicine, S. Lazzaro Hospital, Alba, Cuneo Italy.
Eur J Intern Med. 2020 Oct;80:54-59. doi: 10.1016/j.ejim.2020.05.006. Epub 2020 May 28.
Pulmonary embolism (PE) prevalence in acute exacerbations of COPD is highly variable.
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.
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, PaCO ≤ 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).
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.
COPD 急性加重期患者的肺栓塞（PE）患病率差异很大。
为了研究因 AECOPD 并怀疑患有 PE 而在内科住院的患者中 PE 的患病率和危险因素，我们对因临床怀疑患有 PE 而接受胸部血管计算机断层扫描（angio-CT）的 AECOPD 患者进行了回顾性多中心研究。
共纳入 1043 例患者（平均年龄 75.8 岁±9.7 岁，34.5%为女性）；132 例患者（PE 患病率为 12.66%，95%可信区间为 10.73%，14.77%）经 angio-CT 证实患有 PE，54 例患者在住院期间死亡（5.18%）。多变量分析显示，年龄、女性、深静脉血栓形成的临床体征和症状、高血压、PaCO₂≤40mmHg 和正常胸部 X 线检查与较高的 PE 患病率显著相关。有 0、1、2、3 或≥4 个危险因素的患者的 PE 患病率逐渐从 1.76%增加至 30.43%。PE 患者的平均住院时间（LOH）（15.7 天 vs 14.2 天，p=0.07）和住院死亡率（6.1% vs 5.1%，P=0.62）略高但无统计学意义。
在这种情况下，PE 的患病率不容忽视。一些危险因素可能有助于临床医生识别 PE 风险增加的患者。
