Prevalence of venous thrombo-embolism in acute exacerbations of chronic obstructive pulmonary disease

Objectives: To determine the prevalence of venous thrombo-embolism in patients with acute exacerbations of COPD. Subjects and methods: This was a cross-sectional study involving 105 patients hospitalized with exacerbations of COPD. Clinical and hematological parameters on admission were collected. Multislice computed tomographic pulmonary angiography (CTPA) and ultrasonographic examination of lower limbs, for pulmonary embolism and deep vein thrombosis respectively were done. Wells and Geneva scores were calculated. Results: This study was conducted on 105 COPD patients with acute exacerbations. All of them were males with mean age 49.3 + 8.43. Pulmonary embolism was found in 28.6% of COPD patients who were definitely diagnosed by CTPA while DVT was found in 26.7% of positive cases of pulmonary embolism detected by venous duplex. Wells and Geneva scores were calculated, high probability Wells score was found in 83.3% while Geneva score was likely in 90% of COPD patients proved to have pulmonary embolism. D-dimer and CBC were done; D-dimer was found negative in 90.0% in patients proven not to have pulmonary embolism while was positive in 100% of the diagnosed patients. Regarding CBC; polcythemia was found in 73.3% of diagnosed cases. Conclusion: VTE appeared to be a common problem in COPD patients with exacerbations. The role of CTPA is the cornerstone in the diagnosis of pulmonary embolism. DVT of lower limbs was not essential in all cases of proven pulmonary embolism. Serum D-dimer, Wells criteria and Geneva score are useful bedside criteria that may help to assess the occurrence of VTE in such patients