Pulmonary embolism is a life threatening complication and it is known to recur in some patients. The diagnosis of pulmonary embolism is difficult in chronic pulmonary obstructive disease patients. There can be delay or difficulty due to overlap of the clinical symptoms in these conditions. If the PE is recurrent then also it can be missed in some patients. So, the morbidity and mortality in COPD patients with PE or recurrent PE is higher than those with Leg DVT. So, it is mandatory to look after patients of COPD with PE more closely to avoid the mortality.
PE recurrences according to initial presentation as DVT or PE.
Mortality according to initial presentation as DVT or PE
Respir Res. 2013 Jul 18;14:75. doi: 10.1186/1465-9921-14-75.
Pulmonary embolism and 3-month outcomes in 4036 patients with venous thromboembolism and chronic obstructive pulmonary disease: data from the RIETE registry. Bertoletti L, Quenet S, Laporte S, Sahuquillo JC, Conget F, Pedrajas JM, Martin M, Casado I, Riera-Mestre A, Monreal M; RIETE Investigators. Thrombosis Research Group, EA3065, University Saint-Etienne, Jean Monnet, Saint-Etienne F-42023, France. laurent.bertoletti@gmail.com.
Abstract: Patients with chronic obstructive pulmonary disease (COPD) have a modified clinical presentation of venous thromboembolism (VTE) but also a worse prognosis than non-COPD patients with VTE. As it may induce therapeutic modifications, we evaluated the influence of the initial VTE presentation on the 3-month outcomes in COPD patients.
COPD patients included in the on-going world-wide RIETE Registry were studied. The rate of pulmonary embolism (PE), major bleeding and death during the first 3 months in COPD patients were compared according to their initial clinical presentation (acute PE or deep vein thrombosis(DVT)).
Of the 4036 COPD patients included, 2452 (61%; 95% CI: 59.2-62.3) initially presented with PE. PE as the first VTE recurrence occurred in 116 patients, major bleeding in 101 patients and mortality in 443 patients (Fatal PE: first cause of death). Multivariate analysis confirmed that presenting with PE was associated with higher risk of VTE recurrence as PE (OR, 2.04; 95% CI: 1.11-3.72) and higher risk of fatal PE (OR, 7.77; 95% CI: 2.92-15.7).
COPD patients presenting with PE have an increased risk for PE recurrences and fatal PE compared with those presenting with DVT alone. More efficient therapy is needed in this subtype of patients.
PE recurrences according to initial presentation as DVT or PE.Mortality according to initial presentation as DVT or PE
Pinjala R K
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