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    Venous thromboembolism in patients with chronic obstructive pulmonary disease

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    Authors
    Piazza, Gregory
    Goldhaber, Samuel Z.
    Kroll, Aimee
    Goldberg, Robert J.
    Emery, Catherine
    Spencer, Frederick A.
    UMass Chan Affiliations
    Meyers Primary Care Institute
    Department of Quantitative Health Sciences
    Document Type
    Journal Article
    Publication Date
    2012-10-01
    Keywords
    Venous Thrombosis
    Venous Thromboembolism
    Lung Diseases
    Cardiovascular Diseases
    Epidemiology
    Health Services Research
    Respiratory Tract Diseases
    
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    Link to Full Text
    http://dx.doi.org/10.1016/j.amjmed.2012.03.007
    Abstract
    OBJECTIVE: Our aim was to compare the clinical characteristics, prophylaxis, treatment, and outcomes of venous thromboembolism in patients with and without previously diagnosed chronic obstructive pulmonary disease. METHODS: We analyzed the population-based Worcester Venous Thromboembolism Study of 2488 consecutive patients with validated venous thromboembolism to compare clinical characteristics, prophylaxis, treatment, and outcomes in patients with and without chronic obstructive pulmonary disease. RESULTS: Of 2488 patients with venous thromboembolism, 484 (19.5%) had a history of clinical chronic obstructive pulmonary disease and 2004 (80.5%) did not. Patients with chronic obstructive pulmonary disease were older (mean age 68 vs 63 years) and had a higher frequency of heart failure (35.5% vs 12.9%) and immobility (53.5% vs 43.3%) than patients without chronic obstructive pulmonary disease (all P<.0001). Patients with chronic obstructive pulmonary disease were more likely to die in hospital (6.8% vs 4%, P=.01) and within 30 days of venous thromboembolism diagnosis (12.6% vs 6.5%, P<.0001). Patients with chronic obstructive pulmonary disease demonstrated increased mortality despite a higher frequency of venous thromboembolism prophylaxis. Immobility doubled the risk of in-hospital death (adjusted odds ratio, 2.21; 95% confidence interval, 1.35-3.62) and death within 30 days of venous thromboembolism diagnosis (adjusted odds ratio, 2.04; 95% confidence interval, 1.43-2.91). CONCLUSION: Patients with chronic obstructive pulmonary disease have an increased risk of dying during hospitalization and within 30 days of venous thromboembolism diagnosis. Immobility in patients with chronic obstructive pulmonary disease is an ominous risk factor for adverse outcomes.
    Source
    Am J Med. 2012 Oct;125(10):1010-8. doi: 10.1016/j.amjmed.2012.03.007. Link to article on publisher's site
    DOI
    10.1016/j.amjmed.2012.03.007
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/46560
    PubMed ID
    22884176
    Related Resources
    Link to Article in PubMed
    ae974a485f413a2113503eed53cd6c53
    10.1016/j.amjmed.2012.03.007
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