Incidence of deep venous thrombosis in patients with both Pulmonary Embolism and COPD

Incidence of deep venous thrombosis in patients with both Pulmonary Embolism and COPD

Authors

  • Giorgio Castellana Pulmonary Division, Istituti Clinici Scientifici Maugeri SpA SB Pavia, IRCCS, Institute of Bari, Bari, Italy
  • Pierluigi Intiglietta Respiratory Diseases, University of Bari, Italy
  • Silvano Dragonieri Respiratory Diseases, University of Bari
  • Pierluigi Carratù Internal Medicine “A. Murri”, University of Bari, Italy.
  • Paolo Buonamico Internal Medicine “A. Murri”, University of Bari, Italy.
  • Maria Peragine Internal Medicine “A. Murri”, University of Bari, Italy
  • Alberto Capozzolo Pulmonary Division, Istituti Clinici Scientifici Maugeri SpA SB Pavia, IRCCS, Institute of Bari, Bari, Italy
  • Mauro Carone Pulmonary Division, Istituti Clinici Scientifici Maugeri SpA SB Pavia, IRCCS, Institute of Bari, Bari, Italy
  • Giovanna Elisiana Carpagnano Respiratory Diseases, University of Bari, Italy
  • Onofrio Resta Respiratory Diseases, University of Bari, Italy

Keywords:

Venous thromboembolism; Chronic Obstructive Pulmonary Disease; Pulmonary embolism; In situ thrombosis

Abstract

BACKGROUND. There are no studies investigating populations of patients with both pulmonary embolism and chronic obstructive pulmonary disease (PE-COPD) with and without deep venous thrombosis (DVT).

AIM OF THE STUDY. To define prevalence of DVT in COPD with PE and to compare characteristics of COPD patients who develop PE, with and without DVT. Secondly, we aimed to assess differences in the localization of PE among study groups. 

METHODS. 116 patients with PE were enrolled in a retrospective study. Clinical data as well as echocardiographic and lower limb ultrasonography records were collected for all subjects.

Subjects were divided into two groups according to the presence of COPD: Group 1, 54 patients with diagnosis of PE without COPD and Group 2, 66 patients diagnosed of PE with  COPD. Then, individuals of Group 2 were subdivided in two subgroups according to the presence (n=21) or absence (n=45) of DVT.

RESULTS. 33% of patients with COPD and PE showed DVT.  These subjects had higher PaCO2 and ejection fraction (p<0.05 for all) and higher percentage of chronic renal failure and diabetes mellitus compared to those without DVT (p<0.05 for all). Moreover, in COPD-PE patients with DVT, the most frequent localization was proximal (54% of total), whereas COPD-PE patients without DVT showed a more frequent segmental localization (60% of total). No difference was found in clinical presentation and blood-chemistry tests.

CONCLUSIONS. DVT was non-common in PE-COPD patients. Chronic renal failure, and type 2 diabetes mellitus are more frequent in PE-COPD patients with DVT, that showed a higher frequency of proximal localization, thereby indicating a greater risk of more severe clinical implications. Conversely, PE- COPD subjects without DVT showed a more frequent segmental localization and were less hypercapnic. PE should be taken into account in COPD with worsening of respiratory symptoms, also in absence of DVT.

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Published

01-07-2021

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ORIGINAL ARTICLES

How to Cite

1.
Incidence of deep venous thrombosis in patients with both Pulmonary Embolism and COPD. Acta Biomed [Internet]. 2021 Jul. 1 [cited 2024 Mar. 29];92(3):e2021210. Available from: https://www.mattioli1885journals.com/index.php/actabiomedica/article/view/11258