Takeaway
- Pulmonary embolism (PE) affects 5.9% of patients with COPD hospitalized for acutely worsening respiratory symptoms.
Why this matters
- The prevalence is high enough to warrant studying the effect of systematic screening for PE within 48 hours of hospital admission.
Study design
- Multicenter, cross-sectional cohort study (N=740) with prospective follow-up, 7 French hospitals.
- Prevalence of PE in patients with COPD was assessed with a diagnostic algorithm based on Geneva score, D-dimer levels, and a spiral CT pulmonary angiography and leg compression ultrasound conducted within 48 hours of admission for acutely worsening respiratory symptoms.
- Funding: French Department of Health; others.
Key results
- PE prevalence: 5.9% (95% CI, 4.5%-7.9%).
- Overall 3-month mortality rate: 6.8% (95% CI, 5.2%-8.8%).
- The proportion who died was greater among those with venous thromboembolism at admission vs those without it:
- Risk difference, 20.7% (P<.001>
- Venous thromboembolism prevalence:
- 11.7% (95% CI, 8.6%-15.9%) among patients with suspected PE.
- 4.3% (95% CI, 2.8%-6.6%) among those with unsuspected PE.
Limitations
- Observational.
- Underrepresentation of patients with mild acutely worsening respiratory symptoms and those with severe respiratory failure.
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