PE prevalence nears 6% among patients hospitalized for acutely worsening COPD

  • Couturaud F & al.
  • JAMA
  • 05/01/2021

  • Miriam Davis, PhD
  • Clinical Essentials
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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.