[Relevance of deep venous thrombosis of the leg in patients with acute exacerbated COPD].
BACKGROUND
Acute exacerbation of chronic obstructive pulmonary disease (COPD) is associated with dyspnoea and, consequently, reduced mobility. Immobility is a recognised risk factor for deep venous thrombosis (DVT), but few data exist regarding the prevalence of DVT in acute exacerbation of COPD. Real-time B-mode ultrasonography (US) is a noninvasive screening-method for the diagnosis of DVT. We therefore used US to investigate the prevalence of DVT in patients with an acute exacerbation of COPD.


METHODS
In a prospective cohort study 196 patients with COPD were studied (110 men, 86 female, age: 66.9 +/- 9.1 years, weight: 63.5 +/- 12.7 kg, forced expiratory volume in 1 second [FEV1]: 0.7 +/- 0.21, FEV1% of vital capacity [VC]: 37 +/- 6) in a respiratory intensive care unit on the day of admission. Patients with reduced mobility due to other diseases were excluded. All US were performed by one experienced person with a 5 MHz linear scanner. The veins of the lower extremity were subdivided into 3 segments: 1. The common femoral, 2. superficial femoral veins including the long saphenous vein and 3. the popliteal vein.


RESULTS
In 21 of 196 COPD patients (10.7%) DVT were demonstrated; 18 of these were asymptomatic. Bilateral DVT were not found. In 6 patients additional diagnoses were obtained. There was no difference between patient with and without DVT with respect to age, hemoglobin, PO2, PCO2, pH, FEV1, VC or dyspnoea scale.


CONCLUSIONS
DVT in the lower extremity, which was not detectable on clinical examination, was relatively common in patients with an acute exacerbation of COPD. All measured clinical variables (age, weight, dyspnoe-scale, lung function, hemoglobin and hematocrit and blood gases) failed to predict patients more likely to have DVT.
Schönhofer
B
B
Krankenhaus Kloster Grafschaft, Zentrum für Pneumologie, Beatmungs- und Schlafmedizin, Schmallenberg-Grafschaft.
Köhler
D
D
D000208:Acute Disease; D000368:Aged; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007866:Leg / Q000098:blood supply; D008173:Lung Diseases, Obstructive / Q000150:complications* / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D013924:Thrombophlebitis / Q000000981:diagnostic imaging / Q000209:etiology*; D014463:Ultrasonography; D014680:Veins / Q000000981:diagnostic imaging