OC 63.4 - Prevalence of pulmonary embolism in patients with chronic obstructive pulmonary disease exacerbation in North America – a single center experience

Tuesday, June 27, 2023

15:30 – 15:45 ET

Room: 520

Session Available As: On-Demand

Presenting Author(s)

Vicky Mai, MD MSc (she/her/hers)

MD, MSc
Department of Medicine, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Canada.
Ottawa, Ontario, Canada

Co-Author(s)

MP

Michelle Pradier

BSc
Department of Medicine, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Canada.
Ottawa, Ontario, Canada
SM

Sunita Mulpuru

MD, MSc
Department of Medicine, Faculty of Medicine, Division of Respirology, University of Ottawa, Ottawa, Ontario, Canada.
Ottawa, Ontario, Canada
VT

Venkatesh Thiruganasambandamoorthy

MD, MSc
University of Ottawa, Department of Emergency Medicine, Ottawa, Ontario, Canada.
Ottawa, Ontario, Canada
CC

Catherine Code

MD
Department of Medicine, University of Ottawa, Ottawa, Canada.
Ottawa, Ontario, Canada
Gregoire Le Gal, MD PhD

MD, PhD
Ottawa Hospital Research Institute, University of Ottawa, Canada
Ottawa, Ontario, Canada

Background: Previous studies showed that chronic obstructive pulmonary disease exacerbation (COPDe) increases the risk of pulmonary embolism (PE). The real prevalence of PE in patients with COPDe is still unknown, especially in North America.

Aims: The aim of this study was to evaluate the prevalence of PE in patients with COPDe at a Canadian center.

Methods: This is a retrospective cohort study of adult patients with COPDe seen at the emergency department (ED) of The Ottawa Hospital, Ontario, Canada, from June 2019 to January 2022. The primary outcome was the prevalence of PE during the initial assessment and at 3 months. Secondary outcomes included prevalence of venous thromboembolism and mortality. Subgroup analyses based on the type of exacerbation and the clinical settings were conducted for the prevalence of PE.

Results: Of 1158 patients seen in the ED with COPDe, PE was diagnosed in 13 patients (1.1%; 95%CI 0.6%-1.9%). Five patients (5/1158; 0.4%) had a diagnosis of PE during initial assessment and 8/1141 (0.7%) patients were diagnosed with PE during the 3-month follow-up. The prevalence of PE did not differ based on the type of exacerbation (p=0.27) but was higher in patients admitted to the hospital compared to patients discharged from the ED (1.1% vs 0.0%; p=0.01). Mortality was not statistically higher in patients with PE compared to patients without PE (15.4% vs 6.0%; p=0.19).

Conclusion(s): Among patients with COPDe evaluated in the ED, the prevalence of PE was low, but more than 60% of the PE were diagnosed during the 3-month follow-up. Further studies are needed to determine an appropriate diagnostic algorithm in this specific population.

Learning Objectives:

To understand the prevalence of pulmonary embolism (PE) in patients presenting with a chronic obstructive pulmonary disease exacerbation (COPDe) at the emergency department of a Canadian center.
To learn if the prevalence of PE in these patients varies based on the type of COPDe (purulent or non-purulent exacerbation).
To learn if PE is associated with an increased risk of mortality in patients with COPDe.