COPD is an indipendent risk factor for in-situ pulmonary artery thrombosis

Introduction: Pulmonary embolism (PE) is described in 25% of Chronic Obstructive Pulmonary Disease (COPD) hospitalized patients and may simulate or worsen an episode of acute exacerbation. It should be taken into account in COPD patients with clinical worsening. Aim: To assess whether COPD may be an independent risk factor for PE. Methods: We investigated 91 patients (M:F=1:2, mean age of 69 years) hospitalized for PE at our department from January 2014 to February 2016 and divided them in two groups according to the presence of COPD defined according to GOLD guideline: Group1, PE with COPD (54 patients); Group2, PE without COPD (37 patients). We searched the presence of deep vein thrombosis (DVT), with compression ultrasound sonography plus eco-color doppler, and PE risk factors in all patients. Statistical significance: p ≤0.05. Results: Group1 had less prevalence of DVT (49% vs 66%), next the significance (p=0,09), and of male sex (p=0,009), higher prevalence of smokers (p=0,000), proximal PE (0,04), mean age (p=0,03), paO2 and paCO2 (0,0003) and diabetes than Group2 (p=0,000). No difference was documented in risk factor of PE, i.e. obesity, cancer, atrial fibrillation, liver disease, bed rest and contraceptives. Limiting the analysis to proximal PE, the difference of prevalence of DVT increases (33% Group1 vs. 70% Group2) and becomes significant (p = 0,04). COPD patients without DVT (37) had higher age, lower PaCO2, minor increase in Ddimers, the lower FE, lower prevalence of renal failure (p Conclusion: COPD may be an indipendent risk factor for PE, in particular with proximal location. Absence of DVT is more frequent than in patient without COPD.