Association between features of COPD and risk of venous thromboembolism

Clin Respir J. 2019 Aug;13(8):499-504. doi: 10.1111/crj.13051. Epub 2019 Jun 7.

Abstract

Introduction: Chronic obstructive pulmonary disease (COPD) is associated with risk of venous thromboembolism (VTE) events. A detailed understanding of which clinical features of COPD increase risk of VTE events is needed.

Objectives: To investigate the association between features of COPD and risk of venous thromboembolism.

Methods: A retrospective observational clinical study was conducted on 551 consecutive COPD patients visiting the Department of Respiratory and Critical Care Medicine of Tianjin Chest Hospital between February 2014 and April 2018. Finally, 151 patients were eligible for inclusion. Of these, 29 patients had COPD with VTE and 121 patients had COPD without VTE. Patient informations regarding age, gender, BMI, smoking history, smoking status (package/year), COPD-related symptoms, lung function, number of acute exacerbations and imaging visual emphysema were gathered.

Results: Among the 29 VTE patients, 18 patients had PE and five had DVT, while 6 patients had simultaneous PE and DVT. There were statistically significant differences in GOLD grade, Imaging visual emphysema, and frequent acute exacerbations between the two groups. Multivariate logistic regression analysis showed that after adjustment for gender, age, BMI and smoking history, there were statistically significant for visible emphysema (OR = 3.54, 95% CI: 1.13-11.08; P = 0.03) and GOLD grade (OR = 1.77, 95% CI: 1.04-3.01; P = 0.035), but not for frequent acute exacerbations (OR = 1.65, 95% CI: 0.62-4.38; P = 0.31).

Conclusions: Visual emphysema is an independent risk factor for VTE events and the risk of VTE in COPD patients increases with the degree of airway obstruction. However, there is no evidence of an association between exacerbation frequency and VTE events.

Keywords: COPD; emphysema; frequent acute exacerbations; venous thromboembolism.

Publication types

  • Observational Study

MeSH terms

  • Aged
  • China / epidemiology
  • Disease Progression
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pulmonary Disease, Chronic Obstructive / complications*
  • Pulmonary Disease, Chronic Obstructive / diagnosis
  • Pulmonary Disease, Chronic Obstructive / physiopathology
  • Pulmonary Emphysema / complications
  • Pulmonary Emphysema / diagnostic imaging*
  • Respiratory Function Tests
  • Retrospective Studies
  • Risk Factors
  • Smoking / adverse effects*
  • Smoking / epidemiology
  • Tomography, X-Ray Computed / methods
  • Venous Thromboembolism / epidemiology
  • Venous Thromboembolism / etiology*