title: The prevalence of pulmonary embolism among patients suffering from acute exacerbations of chronic obstructive pulmonary disease.
abstract: The clinical diagnosis of acute pulmonary embolism (PE) in patients with acute exacerbation of chronic obstructive pulmonary disease (COPD) is often difficult due to the similarity in the presenting symptoms of the two conditions. The purpose of this study was to determine the prevalence of PE in patients with acute exacerbation of COPD. Forty-nine consecutive patients admitted to our medical center for acute exacerbation of COPD were investigated for PE (whether or not clinically suspected), following a standardized algorithm based on D-dimer testing and computed tomography pulmonary angiography (CTPA). PE was ruled out by a D-dimer value <500 μg/L in 20 (41 %) patients and by negative CTPA in 40 (82 %). PE was confirmed in 9 patients. The prevalence of PE was 18 %. One patient with normal D-dimer had PE. Presenting symptoms and signs were similar between patients who did and did not have PE. PE was detected in 18 % of COPD patients who were hospitalized for an acute exacerbation. This finding supports the systematic evaluation of PE in hospitalized COPD exacerbated patients.
authors.affiliation: Department of Radiology, Hillel Yaffe Medical Center, P.O.B. 169, Hadera, 38100, Israel.
authors.forename: Mika
authors.initials: M
authors.lastname: Shapira-Rootman
authors.forename: Marinella
authors.initials: M
authors.lastname: Beckerman
authors.forename: Uri
authors.initials: U
authors.lastname: Soimu
authors.forename: Alicia
authors.initials: A
authors.lastname: Nachtigal
authors.forename: Abdel-Rauf
authors.initials: AR
authors.lastname: Zeina
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D000792:Angiography; D015415:Biomarkers / Q000097:blood; D003287:Contrast Media; D003404:Creatinine / Q000097:blood; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000378:metabolism; D006801:Humans; D007479:Iopamidol / Q000031:analogs & derivatives; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications*; D011655:Pulmonary Embolism / Q000097:blood / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D013147:Spirometry; D014057:Tomography, X-Ray Computed
chemical_list: D015415:Biomarkers; D003287:Contrast Media; D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D; C057937:iomeprol; D003404:Creatinine; D007479:Iopamidol