Pulmonary embolism and mortality in patients with COPD.
BACKGROUND
Previous studies suggest that most patients with pulmonary embolism die of their underlying diseases and pulmonary embolism is itself responsible for a minority of deaths. It has not been determined whether pulmonary embolism is associated with increased mortality among patients with different specific diseases.


METHODS
We assessed the mortality in 1,487 patients who had lung scans to pursue the diagnosis of pulmonary embolism. An outcome classification committee prospectively reviewed deaths occurring up to 1 year after each patient's entry into the study.


RESULTS
Ninety-five (23.8%) patients with pulmonary embolism and 189 (18.9%) without pulmonary embolism died within 1 year of study entry (estimated relative risk, 1.34; 95% confidence interval, 1.01 to 1.79). Mortality according to pulmonary embolism status was different among patients with COPD from mortality among patients who did not have COPD (interaction p = 0.03). Of 45 patients with COPD and pulmonary embolism, 24 (53.3%; 95% confidence interval, 38.8 to 67.9%) died within 1 year. After adjustment for patient characteristics, the estimated risk of dying within 1 year was 1.94 times (95% confidence interval, 1.17 to 3.24) for patients with COPD and pulmonary embolism compared with those without pulmonary embolism, and 1.14 (95% confidence interval, 0.85 to 1.54) for patients without COPD (interaction p = 0.08).


CONCLUSIONS
Patients with COPD and pulmonary embolism have an increased 1-year mortality. Further study is needed to clarify the reason(s) for the increase in mortality.
Department of Medicine, University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School, New Brunswick 08903, USA.
J L
JL
Carson
M L
ML
Terrin
A
A
Duff
M A
MA
Kelley
D000328:Adult; D002423:Cause of Death; D015897:Comorbidity; D016001:Confidence Intervals; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006976:Hypertension, Pulmonary / Q000401:mortality; D008173:Lung Diseases, Obstructive / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D016016:Proportional Hazards Models; D011446:Prospective Studies; D011655:Pulmonary Embolism / Q000401:mortality*; D012307:Risk Factors; D015996:Survival Rate; D014481:United States / Q000453:epidemiology