SHENG Fang 1 , ZHANG Jingxi 1 , LIU Jinming 2 , WANG Lan 2 , LIU Minqi 2
  • 1. Department of Respiratory and Critical Care Medicine, The Navy Medical University, Shanghai 200433, P. R. China;
  • 2. Pulmonary Circulation Department, Shanghai Pulmonary Hospital, Shanghai 200433, P. R. China;
ZHANG Jingxi, Email: jingxizhang2000@126.com
Chronic obstructive pulmonary disease; Venous thromboembolism; Risk factors; Regression analysis
10.7507/1671-6205.201807030
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Objective To analyze the risk factors of venous thromboembolism (VTE) in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and to provide a theoretical basis for the prevention and treatment of AECOPD combined with VTE.Methods A total of 413 AECOPD patients admitted to Pulmonary Department of Pulmonary Hospital and our hospital from February 2014 to September 2017 were selected as the study subjects. The patients of AECOPD with VTE were determined by the results of lower extremity venous ultrasound and CT pulmonary angiography. The incidence of AECOPD patients with VTE was calculated. Patients with AECOPD with VTE were assigned to the VTE group and AECOPD without VTE to non-VTE group. All the patient's gender, age and other general information, lower extremity pain swelling, walking difficulties, fever and other clinical symptoms, bed rest, hormone use, diuretic use of treatment information, laboratory tests and other indicators were collected. SPSS 20.0 was used for statistical analysis. T-test or rank sum test was used to compare between groups. Chi-square test was used to count data, and the results of univariate analysis were included in logistic regression analysis to analyze the risk factors of VTE in patients with AECOPD.Results The incidence of VTE in patients with AECOPD was 12.59%. Increasing heart rate, pulmonary infarction "triple symptoms" the proportion of PTE patients with higher than the number of patients with deep vein thrombosis (DVT), the difference was statistically significant (P<0.05). PaO2, PaCO2, SpO2, and FEV1%pred in PTE patients of PTE were lower than those in DVT patients, pulmonary artery systolic pressure was higher than DVT patients, the difference was statistically significant (P<0.05). History of venous thrombosis (OR=1.986, P=0.031), lower extremity pain (OR=7.376, P=0.019), bed-staying duration≥3 d (OR=3.325, P=0.001) and D-dimer increase (OR=9.628, P=0.000) were independent risk factors for VTE in AECOPD patients.Conclusions The incidence of AECOPD patients with VTE is high, which needs to be paid attention. Observation should be enhanced for those AECOPD patients with risk factors such as history of venous thrombosis, lower extremity pain, bed-staying duration≥3 d and D-dimer increase in clinical work. If possible, imaging studies should be carried out as soon as possible to make early diagnosis.

Citation： SHENG Fang, ZHANG Jingxi, LIU Jinming, WANG Lan, LIU Minqi. Risk factors of venous thromboembolism among patients with acute exacerbation of chronic obstructive pulmonary disease. Chinese Journal of Respiratory and Critical Care Medicine, 2019, 18(5): 427-431. doi: 10.7507/1671-6205.201807030 Copy

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