Jin Chunhua, Hu Yanping, Liu Fang
Emergency Department of Shaoxing People's Hospital, Shaoxing, Zhejiang, China.
Emergency Department, Dalian University Affiliated Xinhua Hospital, Dalian, Liaoning, China.
Front Med (Lausanne). 2025 May 14;12:1421169. doi: 10.3389/fmed.2025.1421169. eCollection 2025.
The objective of this research is to examine the occurrence, clinical manifestations, and determinants of pulmonary embolism (PE) in older individuals diagnosed with chronic obstructive pulmonary disease (COPD).
A retrospective analysis was performed on elderly patients diagnosed with COPD, who were admitted to five different hospitals within our province. These patients were categorized into two groups based on the presence or absence of pulmonary embolism (PE). And systematically compile and examine the foundational data, clinical attributes, and pertinent laboratory parameters outlined in their respective medical records. These encompass blood routine, arterial blood gas analysis, coagulation markers, and biochemical indicators.
A total of 958 elderly patients with COPD were included in the study. Among them, 121 patients (12.63%) were found to have complications with PE. During hospitalization, 50 cases (5.22%) resulted in death. In the multivariate analysis, several factors were found to be significantly associated with a higher prevalence of PE, including age, female gender, deep vein thrombosis, hypertension, PaCO ≤ 40 mmHg, and normal clinical signs and symptoms on chest X-rays ( < 0.05). The RDW-SD and RDW-CV values of the COPD combined with the PE group were significantly higher compared to those of the COPD without PE group ( < 0.001). The risk of PE caused by higher RDW-SD was significantly greater than that caused by lower RDW-SD ( < 0.05). The area under the curve for RDW-SD in predicting PE is 0.723. The critical value of RDW-SD was determined to be 46.25, with a sensitivity of 75.59% and a specificity of 67.5%.
It is essential to give careful attention to the prevalence and factors that put elderly patients with COPD at risk for PE. The utilization of RDW could potentially serve as a predictive tool for identifying the onset of PE in COPD patients.
本研究的目的是调查诊断为慢性阻塞性肺疾病（COPD）的老年人肺栓塞（PE）的发生率、临床表现及决定因素。
对我省五家不同医院收治的诊断为COPD的老年患者进行回顾性分析。这些患者根据是否存在肺栓塞（PE）分为两组。并系统整理和检查其各自病历中列出的基础数据、临床特征及相关实验室参数。这些包括血常规、动脉血气分析、凝血标志物及生化指标。
本研究共纳入958例老年COPD患者。其中，121例患者（12.63%）并发PE。住院期间，50例（5.22%）死亡。在多因素分析中，发现几个因素与PE的较高患病率显著相关，包括年龄、女性、深静脉血栓形成、高血压、PaCO₂≤40 mmHg以及胸部X线片上正常的临床体征和症状（P<0.05）。与无PE的COPD组相比，COPD合并PE组的RDW-SD和RDW-CV值显著更高（P<0.001）。较高的RDW-SD导致PE的风险显著大于较低的RDW-SD（P<0.05）。RDW-SD预测PE的曲线下面积为0.723。确定RDW-SD的临界值为46.25，敏感性为75.59%，特异性为67.5%。
必须密切关注老年COPD患者发生PE的患病率及危险因素。RDW的应用可能作为识别COPD患者PE发病的预测工具。
