title: Risk Factors for Venous Thromboembolism in Chronic Obstructive Pulmonary Disease.
abstract: BACKGROUND
  COPD patients are at increased risk for venous thromboembolism (VTE). VTE however remains under-diagnosed in this population and the clinical profile of VTE in COPD is unclear.
  
  
  METHODS
  Global initiative for chronic Obstructive Lung Disease (GOLD) stages II-IV participants in the COPD Genetic Epidemiology (COPDGene) study were divided into 2 groups: VTE+, those who reported a history of VTE by questionnaire, and VTE-, those who did not. We compared variables in these 2 groups with either t-test or chi-squared test for continuous and categorical variables, respectively. We performed a univariate logistic regression for VTE, and then a multivariate logistic regression using the significant predictors of interest in the univariate analysis to ascertain the determinants of VTE.
  
  
  RESULTS
  The VTE+ group was older, more likely to be Caucasian, had a higher body mass index (BMI), smoking history, used oxygen, had a lower 6-minute walk distance, worse quality of life scores, and more dyspnea and respiratory exacerbations than the VTE- group. Lung function was not different between groups. A greater percentage of the VTE+ group described multiple medical comorbidities. On multivariate analysis, BMI, 6-minute walk distance, pneumothorax, peripheral vascular disease, and congestive heart failure significantly increased the odds for VTE by history.
  
  
  CONCLUSIONS
  BMI, exercise capacity, and medical comorbidities were significantly associated with VTE in moderate to severe COPD. Clinicians should suspect VTE in patients who present with dyspnea and should consider possibilities other than infection as causes of COPD exacerbation.
authors.affiliation: Section of Pulmonary and Critical Care Medicine, Department of Medicine, Temple University School of Medicine, Philadelphia, Pennsylvania.
authors.forename: Victor
authors.initials: V
authors.lastname: Kim
authors.affiliation: Section of Pulmonary and Critical Care Medicine, Department of Medicine, Temple University School of Medicine, Philadelphia, Pennsylvania.
authors.forename: Nishant
authors.initials: N
authors.lastname: Goel
authors.affiliation: Section of Pulmonary and Critical Care Medicine, Department of Medicine, Temple University School of Medicine, Philadelphia, Pennsylvania.
authors.forename: Jinal
authors.initials: J
authors.lastname: Gangar
authors.affiliation: Section of Pulmonary and Critical Care Medicine, Department of Medicine, Temple University School of Medicine, Philadelphia, Pennsylvania.
authors.forename: Huaqing
authors.initials: H
authors.lastname: Zhao
authors.affiliation: Section of Pulmonary and Critical Care Medicine, Department of Medicine, Temple University School of Medicine, Philadelphia, Pennsylvania.
authors.forename: David E
authors.initials: DE
authors.lastname: Ciccolella
authors.affiliation: Division of Pulmonary and Critical Care Medicine and Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
authors.forename: Edwin K
authors.initials: EK
authors.lastname: Silverman
authors.affiliation: Division of Pulmonary, Critical Care and Sleep Medicine, National Jewish Health, University of Colorado, School of Medicine, Denver.
authors.forename: James D
authors.initials: JD
authors.lastname: Crapo
authors.affiliation: Section of Pulmonary and Critical Care Medicine, Department of Medicine, Temple University School of Medicine, Philadelphia, Pennsylvania.
authors.forename: Gerard J
authors.initials: GJ
authors.lastname: Criner
keywords: COPD; PVD; VTE; peripheral vascular disease; pulmonary embolism; venous thromboembolism
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