The Prevalence and Predicting Factors of Pulmonary Thromboembolism in Patients with Exacerbated Chronic Obstructive Pulmonary Disease

Introduction: The risk of pulmonary thromboembolism (PTE) in patients with exacerbated chronic obstructive pulmonary disease (e-COPD) is higher than in non-COPD states. The study aimed to evaluate the prevalence and the parameters that are critical for finding the incidence of PTE in patients with e-COPD. Material and methods: This cross-sectional study was performed on 68 consecutive patients with the e-COPD, referred to the Pulmonary Disease Department at the Shariati Hospital in Tehran between 2013 and 2014. In addition to collecting data on the history of disease and physical examination, arterial blood sampling, spirometry, electrocardiography and echocardiography were performed for all patients. All subjects underwent computed tomography pulmonary angiography (CT-PA) as a method of choice for diagnosing PTE. Results: Out of 68 cases, five (7.4%) had CT angiography findings suggesting PTE. These patients were all male and had a higher mean age (79 vs. 65 years), lower mean systolic blood pressure (88.36 vs. 118.33 mmHg), and a higher mean heart rate (133.12 vs 90.33 beats/min), compared to e-COPD patients without PTE. Arterial blood gas analysis in individuals with PTE demonstrated a lower HCO₃ (2.33 vs. 9.44 mEq/l) and PCO₂ (44.35 vs. 51.43 mm Hg) levels. The mean left ventricular ejection fraction (LVEF) was lower in patients with PTE (34.14 ± 4.49% vs. 46.94 ± 8.27%). Conclusion: The prevalence of PTE in our series of patients with e-COPD was 7.4%. According to the study results, male gender, advanced age, hypotension, tachycardia, and respiratory alkalosis are factors indicating possible PTE among subjects with e- COPD.