Prevalence and characteristics of venous thromboembolism in severe exacerbation of chronic obstructive pulmonary disease in a tertiary care hospital in India

https://doi.org/10.4081/monaldi.2021.1742

Authors

  • Soibam Pahel Meitei | dr.pmsoibam@gmail.com All India Institute of Medical Sciences - Rishikesh, India. https://orcid.org/0000-0001-5548-0708
  • Sudheer Tale Department of Pulmonary Medicine, All India Institute of Medical Sciences, Rishikes, India.
  • Arjun Kumar Negi Department of Pulmonary Medicine, All India Institute of Medical Sciences, Rishikes, India. https://orcid.org/0000-0002-5581-6176
  • Ruchi Dua Department of Pulmonary Medicine, All India Institute of Medical Sciences, Rishikes, India.
  • Rohit Walia Department of Cardiology, All India Institute of Medical Sciences, Rishikes, India. https://orcid.org/0000-0001-9405-5990
  • Sudhir Saxena Department of Radiodiagnosis, All India Institute of Medical Sciences, Rishikes, India. https://orcid.org/0000-0002-5576-1646

Abstract

Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) carries a high risk of venous thromboembolism (VTE). Pulmonary embolism (PE) and AECOPD increase the mortality and morbidity risk associated with each other. Racial and ethnic differences in VTE risk have been documented in multiple studies. However, there is a dearth of reliable Indian data on the same. This study was planned to find the prevalence of VTE in the setting of severe AECOPD in a tertiary care hospital in India and to identify the clinical, laboratory and radiological characteristics of VTE in severe AECOPD. A total of 156 consecutive patients admitted with severe AECOPD and meeting the specified inclusion and exclusion criteria were recruited. Thorough workup of all patients was done including ABG, serum D dimer, ECG, compression ultrasound of lower limbs and 2-D echocardiography. Patients with high pre-test probability score, or intermediate pre-test probability score at presentation with serum D dimer above the age adjusted cut-off underwent computerised tomography pulmonary angiography (CTPA).  Results were analysed using SPSS version 23.  Sixteen (10.3%) patients had VTE, 15 (93.75%) of them being cases of isolated PE. Female gender, higher cumulative past exposure to corticosteroid, higher alveolar-arterial gradient, right ventricular dysfunction, and higher mean pulmonary artery pressure were associated with increased risk for VTE. The prevalence of VTE in AECOPD in this study among an Indian population is higher than among other Asians, but lower than among the Blacks, the Caucasians and the Middle-East ethnicities. Since a vast majority of VTE presents as PE without DVT in the setting of AECOPD, the absence of deep vein thrombosis of lower limbs does not rule PE in the setting.

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Published
2021-03-16
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Pneumology - Original Articles
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Keywords:
Compression ultrasound, chronic obstructive pulmonary disease, CT pulmonary angiography, pulmonary embolism, venous thromboembolism.
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How to Cite
Meitei, Soibam Pahel, Sudheer Tale, Arjun Kumar Negi, Ruchi Dua, Rohit Walia, and Sudhir Saxena. 2021. “Prevalence and Characteristics of Venous Thromboembolism in Severe Exacerbation of Chronic Obstructive Pulmonary Disease in a Tertiary Care Hospital in India”. Monaldi Archives for Chest Disease, March. https://doi.org/10.4081/monaldi.2021.1742.