{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,4]],"date-time":"2025-10-04T07:59:36Z","timestamp":1759564776438,"version":"3.40.5"},"reference-count":49,"publisher":"PAGEPress Publications","issue":"4","license":[{"start":{"date-parts":[[2021,3,16]],"date-time":"2021-03-16T00:00:00Z","timestamp":1615852800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Monaldi Arch Chest Dis"],"abstract":"<jats:p>Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) carries a high risk of venous thromboembolism (VTE). Pulmonary embolism (PE) and AECOPD increase the mortality and morbidity risk associated with each other. Racial and ethnic differences in VTE risk have been documented in multiple studies. However, there is a dearth of reliable Indian data on the same. This study was planned to find the prevalence of VTE in the setting of severe AECOPD in a tertiary care hospital in India and to identify the clinical, laboratory and radiological characteristics of VTE in severe AECOPD. A total of 156 consecutive patients admitted with severe AECOPD and meeting the specified inclusion and exclusion criteria were recruited. Thorough workup of all patients was done including ABG, serum D dimer, ECG, compression ultrasound of lower limbs and 2-D echocardiography. Patients with high pre-test probability score, or intermediate pre-test probability score at presentation with serum D dimer above the age adjusted cut-off underwent computerised tomography pulmonary angiography (CTPA). \u00a0Results were analysed using SPSS version 23. \u00a0Sixteen (10.3%) patients had VTE, 15 (93.75%) of them being cases of isolated PE. Female gender, higher cumulative past exposure to corticosteroid, higher alveolar-arterial gradient, right ventricular dysfunction, and higher mean pulmonary artery pressure were associated with increased risk for VTE. The prevalence of VTE in AECOPD in this study among an Indian population is higher than among other Asians, but lower than among the Blacks, the Caucasians and the Middle-East ethnicities. Since a vast majority of VTE presents as PE without DVT in the setting of AECOPD, the absence of deep vein thrombosis of lower limbs does not rule PE in the setting.<\/jats:p>","DOI":"10.4081\/monaldi.2021.1742","type":"journal-article","created":{"date-parts":[[2021,3,17]],"date-time":"2021-03-17T14:36:25Z","timestamp":1615991785000},"source":"Crossref","is-referenced-by-count":5,"title":["Prevalence and characteristics of venous thromboembolism in severe exacerbation of chronic obstructive pulmonary disease in a tertiary care hospital in India"],"prefix":"10.4081","volume":"91","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5548-0708","authenticated-orcid":false,"given":"Soibam Pahel","family":"Meitei","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sudheer","family":"Tale","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5581-6176","authenticated-orcid":false,"given":"Arjun Kumar","family":"Negi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ruchi","family":"Dua","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9405-5990","authenticated-orcid":false,"given":"Rohit","family":"Walia","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5576-1646","authenticated-orcid":false,"given":"Sudhir","family":"Saxena","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2549","published-online":{"date-parts":[[2021,3,16]]},"reference":[{"unstructured":"Shapira-Rootman M, Beckerman M, Soimu U, et al. The prevalence of pulmonary embolism among patients suffering","key":"12891"},{"doi-asserted-by":"crossref","unstructured":"from acute exacerbations of chronic obstructive pulmonary disease. Emerg Radiol 2015;22:257\u201360.","key":"12892","DOI":"10.1007\/s10140-014-1280-7"},{"unstructured":"Aleva FE, Voets LWLM, Simons SO, et al. Prevalence and localization of pulmonary embolism in unexplained acute","key":"12893"},{"doi-asserted-by":"crossref","unstructured":"exacerbations of COPD: a systematic review and meta-analysis. Chest 2017;151:544\u201354.","key":"12894","DOI":"10.1016\/j.chest.2016.07.034"},{"doi-asserted-by":"crossref","unstructured":"Pineda LA, Hathwar VS, Grant BJ. Clinical suspicion of fatal pulmonary embolism. Chest 2001;120:791\u20135.","key":"12895","DOI":"10.1378\/chest.120.3.791"},{"doi-asserted-by":"crossref","unstructured":"Sidney S, Sorel M, Quesenberry CP, et al. COPD and incident cardiovascular disease hospitalizations and mortality: Kaiser Permanente Medical Care Program. Chest 2005;128:2068\u201375.","key":"12896","DOI":"10.1378\/chest.128.4.2068"},{"doi-asserted-by":"crossref","unstructured":"Saghazadeh A, Rezaei N. Inflammation as a cause of venous thromboembolism. Crit Rev Oncol Hematol 2016;99:272\u201385.","key":"12897","DOI":"10.1016\/j.critrevonc.2016.01.007"},{"doi-asserted-by":"crossref","unstructured":"Hurst JR, Perera WR, Wilkinson TMA, et al. Systemic and upper and lower airway inflammation at exacerbation of chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2006;173:71\u20138.","key":"12898","DOI":"10.1164\/rccm.200505-704OC"},{"doi-asserted-by":"crossref","unstructured":"Goldhaber SZ, Visani L, De Rosa M. Acute pulmonary embolism: clinical outcomes in the International Cooperative Pulmonary Embolism Registry (ICOPER). Lancet 1999;353:1386\u20139.","key":"12899","DOI":"10.1016\/S0140-6736(98)07534-5"},{"doi-asserted-by":"crossref","unstructured":"Lesser B. The diagnosis of acute pulmonary embolism in patients with chronic obstructive pulmonary disease. Chest 1992:17\u201322.","key":"12900","DOI":"10.1378\/chest.102.1.17"},{"doi-asserted-by":"crossref","unstructured":"Tillie-Leblond I, Marquette C-H, Perez T, et al. Pulmonary embolism in patients with unexplained exacerbation of chronic obstructive pulmonary disease: prevalence and risk factors. Ann Intern Med 2006;144:390\u20136.","key":"12901","DOI":"10.7326\/0003-4819-144-6-200603210-00005"},{"doi-asserted-by":"crossref","unstructured":"White RH, Keenan CR. Effects of race and ethnicity on the incidence of venous thromboembolism. Thromb Res 2009;123:S11-17.","key":"12902","DOI":"10.1016\/S0049-3848(09)70136-7"},{"doi-asserted-by":"crossref","unstructured":"Tran H. The risk of venous thromboembolism is lower in multiple Asian ethnic groups. Circulation 2018;137:AMP 18.","key":"12903","DOI":"10.1161\/circ.137.suppl_1.mp18"},{"unstructured":"Dutt TS, Udwadia ZF. Prevalence of venous thromboembolism in acute exacerbations of chronic obstructive pulmonary disease: an Indian perspective. Indian J Chest Dis Allied Sci 2011;53:207\u201310.","key":"12904"},{"unstructured":"Global Initiative for Obstructive Lung Disease. Accessed 8 Jan 2019. Available from: http:\/\/goldcopd.org\/","key":"12905"},{"doi-asserted-by":"crossref","unstructured":"Raja AS, Greenberg JO, Qaseem A, et al. Evaluation of patients with suspected acute pulmonary embolism: best practice advice from the Clinical Guidelines Committee of the American College of Physicians. Ann Intern Med 2015;163:701.","key":"12906","DOI":"10.7326\/M14-1772"},{"doi-asserted-by":"crossref","unstructured":"Kahn SR, Lim W, Dunn AS, et al. Prevention of VTE in nonsurgical patients. 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Perm J 2011;15:75.","key":"12932","DOI":"10.7812\/TPP\/11-112"},{"doi-asserted-by":"crossref","unstructured":"Matthews JC, McLaughlin V. Acute right ventricular failure in the setting of acute pulmonary embolism or chronic pulmonary hypertension: a detailed review of the pathophysiology, diagnosis, and management. Curr Cardiol Rev 2008;4:49\u201359.","key":"12933","DOI":"10.2174\/157340308783565384"},{"doi-asserted-by":"crossref","unstructured":"Gu\u0308nay E, Sar\u0131n\u00e7 Ula\u015fl\u0131 S, Akar O, et al. Neutrophil-to-lymphocyte ratio in chronic obstructive pulmonary disease: a retrospective study. Inflammation 2014;37:374\u201380.","key":"12934","DOI":"10.1007\/s10753-013-9749-1"},{"doi-asserted-by":"crossref","unstructured":"Furutate R, Ishii T, Motegi T, et al. The neutrophil to lymphocyte ratio is related to disease severity and exacerbation in patients with chronic obstructive pulmonary disease. 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The levels of serum pro-calcitonin and high-sensitivity C-reactive protein in the early diagnosis of chronic obstructive pulmonary disease during acute exacerbation. 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