title: Incidence of pulmonary embolism during COPD exacerbation.
abstract: OBJECTIVE
  Because pulmonary embolism (PE) and COPD exacerbation have similar presentations and symptoms, PE can be overlooked in COPD patients. Our objective was to determine the prevalence of PE during COPD exacerbation and to describe the clinical aspects in COPD patients diagnosed with PE.
  
  
  METHODS
  This was a prospective study conducted at a university hospital in the city of Ankara, Turkey. We included all COPD patients who were hospitalized due to acute exacerbation of COPD between May of 2011 and May of 2013. All patients underwent clinical risk assessment, arterial blood gas analysis, chest CT angiography, and Doppler ultrasonography of the lower extremities. In addition, we measured D-dimer levels and N-terminal pro-brain natriuretic peptide (NT-pro-BNP) levels.
  
  
  RESULTS
  We included 172 patients with COPD. The prevalence of PE was 29.1%. The patients with pleuritic chest pain, lower limb asymmetry, and high NT-pro-BNP levels were more likely to develop PE, as were those who were obese or immobile. Obesity and lower limb asymmetry were independent predictors of PE during COPD exacerbation (OR = 4.97; 95% CI, 1.775-13.931 and OR = 2.329; 95% CI, 1.127-7.105, respectively).
  
  
  CONCLUSIONS
  The prevalence of PE in patients with COPD exacerbation was higher than expected. The association between PE and COPD exacerbation should be considered, especially in patients who are immobile or obese.
authors.affiliation: Ufuk University School of Medicine, Department of Chest Diseases, Ankara, Turkey, MD. Department of Chest Diseases, Ufuk University School of Medicine, Ankara, Turkey.
authors.forename: Evrim Eylem
authors.initials: EE
authors.lastname: Akpinar
authors.affiliation: Ufuk University, School of Medicine, Department of Chest Diseases, Ankara, Turkey, MD. Department of Chest Diseases, Ufuk University School of Medicine, Ankara, Turkey.
authors.forename: Derya
authors.initials: D
authors.lastname: Hoşgün
authors.affiliation: Chest Surgery Training Hospital, Ankara, Turkey, MD. Atatürk Chest Diseases and Chest Surgery Training Hospital, Ankara, Turkey.
authors.forename: Serdar
authors.initials: S
authors.lastname: Akpinar
authors.affiliation: Ufuk University, School of Medicine, Department of Radiology, Ankara, Turkey, MD. Department of Radiology, Ufuk University School of Medicine, Ankara, Turkey.
authors.forename: Gökçe Kaan
authors.initials: GK
authors.lastname: Ataç
authors.affiliation: Ankara University, School of Medicine, Department of Biostatistics, Ankara, Turkey, PhD. Department of Biostatistics, Ankara University School of Medicine, Ankara, Turkey.
authors.forename: Beyza
authors.initials: B
authors.lastname: Doğanay
authors.affiliation: Ufuk University, School of Medicine, Department of Chest Diseases, Ankara, Turkey, Chief. Department of Chest Diseases School of Medicine, Ufuk University, Ankara, Turkey.
authors.forename: Meral
authors.initials: M
authors.lastname: Gülhan
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*; D011655:Pulmonary Embolism / Q000175:diagnosis* / Q000453:epidemiology* / Q000209:etiology; D012307:Risk Factors; D014057:Tomography, X-Ray Computed; D014421:Turkey / Q000453:epidemiology; D018615:Ultrasonography, Doppler, Color