Inflammatory Biomarkers as Predictors of Symptomatic Venous Thromboembolism in Hospitalized Patients with AECOPD: A Multicenter Cohort Study.

Abstract

Aim: Venous thromboembolism (VTE) risk significantly increases in patients with an acute exacerbation of chronic obstructive pulmonary disease (AECOPD), which is characterized by an enhanced inflammatory response. This study aimed to evaluate the predictive value of inflammatory biomarkers for VTE in AECOPD.

Methods: A prospective, multicenter study was conducted to include patients hospitalized for AECOPD. Inflammatory biomarkers on admission were compared between the patients who developed VTE during hospitalization and the patients without VTE. A logistic regression analysis was used to identify inflammatory biomarkers with an independently predictive value.

Results: Among the 13,531 AECOPD inpatients, 405 (2.99%) developed VTE during hospitalization. Patients who developed VTE had higher levels of inflammatory biomarkers, including the white blood cell count, neutrophil percentage, systemic immune/inflammatory index, neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio, C-reactive protein (CRP), procalcitonin (PCT), and lactate dehydrogenase (LDH), and lower lymphocyte and eosinophil ratios (ESOR), platelet, and albumin (p all ＜0.05). NLR, LDH, CRP, PCT, and ESOR were identified as independent predictors of VTE (odds ratios (ORs) were 2.22, 1.95, 1.64, 1.59, and 1.37, respectively). The incidence of VTE increased with increasing NLR, LDH, CRP, and PCT quartiles, and a decreasing ESOR quartile. Among them, NLR and LDH had predictive capabilities for VTE that were comparable to the widely used Padua and IMPROVE scores.

Conclusion: Easily available inflammatory parameters, such as NLR and LDH, can identify AECOPD patients at increased risk for VTE who may therefore be candidates for thromboprophylaxis.