Pneumology Department, Hospital General Universitario Gregorio Marañón, Universidad Complutense de Madrid, CIBER de Enfermedades Respiratorias (CIBERES), Madrid. Spain.
Department of Public Health & Maternal and Child Health. Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain.
Eur J Intern Med. 2021 Feb;84:18-23. doi: 10.1016/j.ejim.2020.11.009. Epub 2020 Nov 26.
To examine the incidence, clinical characteristics, and in-hospital outcomes of pulmonary embolism (PE) among hospitalized patients with or without chronic obstructive pulmonary disease (COPD) in Spain, and to identify predictors of in-hospital-mortality (IHM) after PE among patients with and without COPD.
We included all patients aged ≥ 40 years who were hospitalised for PE between 2016 and 2018. Data were collected from the Spanish National Hospital Discharge Database.
We identified 47,190 hospitalizations for PE during the study period, 7.49% with COPD. Adjusted incidence of PE was higher in COPD patients than in those without COPD (IRR 1.16; 95%CI 1.13-1.19). Crude IHM was significantly higher in PE hospitalized patients with COPD than in those without COPD (9.86% vs 3.59%; p<0.001). Predictor factors of IHM in COPD patients with PE included older age, higher Charlson comorbidity index, atrial fibrillation, massive PE and dependence on oxygen prior to hospital admission. However, obesity was associated with lower IHM. For PE hospitalized patients, suffering COPD increased the probability of dying in the hospital (adjusted OR 2.84; 95%CI 2.27-3.55).
Our results revealed that incidence of PE was higher in COPD patients than in those without COPD. Furthermore, COPD was a risk factor for IHM after PE.
在西班牙，研究住院伴有或不伴有慢性阻塞性肺疾病（COPD）的患者中肺栓塞（PE）的发生率、临床特征和住院结局，并确定伴有和不伴有 COPD 的 PE 患者住院死亡率（IHM）的预测因素。
我们纳入了 2016 年至 2018 年期间因 PE 住院的所有年龄≥40 岁的患者。数据来自西班牙国家住院患者数据库。
研究期间共确定了 47190 例 PE 住院患者，其中 7.49%患有 COPD。与无 COPD 的患者相比，COPD 患者的 PE 调整发病率更高（IRR 1.16；95%CI 1.13-1.19）。患有 COPD 的 PE 住院患者的住院死亡率明显高于无 COPD 的患者（9.86%比 3.59%；p<0.001）。患有 COPD 的 PE 患者 IHM 的预测因素包括年龄较大、较高的 Charlson 合并症指数、心房颤动、大量 PE 和住院前依赖氧气。然而，肥胖与较低的 IHM 相关。对于 PE 住院患者，患有 COPD 会增加在医院死亡的概率（调整 OR 2.84；95%CI 2.27-3.55）。
我们的研究结果显示，COPD 患者的 PE 发生率高于无 COPD 的患者。此外，COPD 是 PE 后 IHM 的一个危险因素。
