Prevalence and characteristics of venous thromboembolism in severe exacerbation of COPD in a tertiary care hospital in India

Abstract

Introduction: 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.

Aims: 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.

Methodology: 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, 2 D echocardiography, and CT Pulmonary Angiography as indicated. Results were analysed using SPSS version 23.

Results: 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 oxygen gradient, right ventricular dysfunction, and high mean pulmonary arterial pressure were associated with increased risk for VTE.

Conclusion: Prevalence of VTE in AECOPD is higher among Indians than among other Asian ethnicities but lower than among the Blacks, the Caucasians, and the Middle-East ethnicities. The absence of deep vein thrombosis of lower limbs does not rule out PE in the setting of AECOPD.