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Venous thromboembolism in patients with chronic obstructive pulmonary disease
Quantitative Health Sciences Publications and Presentations
  • Gregory Piazza, Harvard Medical School
  • Samuel Z. Goldhaber, Harvard Medical School
  • Aimee Kroll, University of Massachusetts Medical School
  • Robert J. Goldberg, University of Massachusetts Medical School
  • Catherine Emery, University of Massachusetts Medical School
  • Frederick A. Spencer, University of Massachusetts Medical School
UMMS Affiliation
Department of Quantitative Health Sciences; Meyers Primary Care Institute
Publication Date
10-1-2012
Document Type
Article
Subjects
Venous Thrombosis; Venous Thromboembolism; Lung Diseases
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.
Comments

Citation: Am J Med. 2012 Oct;125(10):1010-8. doi: 10.1016/j.amjmed.2012.03.007. Link to article on publisher's site

Related Resources
Link to Article in PubMed
Citation Information
Gregory Piazza, Samuel Z. Goldhaber, Aimee Kroll, Robert J. Goldberg, et al.. "Venous thromboembolism in patients with chronic obstructive pulmonary disease" Vol. 125 Iss. 10 (2012) ISSN: 0002-9343 (Linking)
Available at: http://works.bepress.com/robert_goldberg/354/