{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T16:17:17Z","timestamp":1787847437671,"version":"build-2784847793"},"reference-count":20,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Chronic obstructive pulmonary disease (COPD) is the leading cause of respiratory morbidity and mortality. Patients with COPD have an increased risk of pulmonary thromboembolism (PTE), which complicates clinical management. This study aimed to evaluate the frequency of PTE in patients with COPD exacerbations and to identify clinical and laboratory predictive factors associated with PTE.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>A retrospective cross-sectional study was conducted at Al-Zahra Hospital, Isfahan, Iran, between 2021-2022. Patients diagnosed with COPD exacerbation and shortness of breath were assessed for PTE by using computed tomography pulmonary angiography. Clinical data, including demographics, blood gas levels, and ECG and echocardiography findings, were collected and analyzed using SPSS 24 software.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Among the 260 COPD patients, 26 (10%) were diagnosed with PTE. Patients with PTE exhibited significantly higher body mass index (BMI), smoking and D-dimer levels, and lower oxygen saturation. Logistic regression analysis identified older age, BMI, smoking, and abnormal electrocardiogram (ECG) as independent predictors of PTE (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001 for all).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>This study highlights the notable prevalence of PTE in patients with COPD exacerbations. Factors such as obesity, smoking, and abnormal ECG findings are critical in predicting the risk of PTE. These findings underscore the necessity for vigilant assessment and management of PTE in COPD patients to improve clinical outcomes in this vulnerable population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/abr.abr_219_24","type":"journal-article","created":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T11:00:26Z","timestamp":1780138826000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Frequency of Pulmonary Embolism in Patients with COPD Exacerbation and Clinical and Laboratory Predictive Factors"],"prefix":"10.4103","volume":"15","author":[{"given":"Shahrzad","family":"Keymanesh","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Somayeh","family":"Sadeghi","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,3]]},"reference":[{"key":"R1-20260530","doi-asserted-by":"crossref","first-page":"1248","DOI":"10.1056\/NEJMra1900475","article-title":"Update on the pathogenesis of chronic obstructive pulmonary disease","volume":"381","author":"Agust\u00ed","year":"2019","journal-title":"N Engl J Med"},{"key":"R2-20260530","doi-asserted-by":"crossref","first-page":"439","DOI":"10.2147\/COPD.S234942","article-title":"Economic burden of chronic obstructive pulmonary disease (COPD): A systematic literature review","volume":"15","author":"Iheanacho","year":"2020","journal-title":"Int J Chron Obstruct Pulmon Dis"},{"key":"R3-20260530","doi-asserted-by":"crossref","first-page":"421","DOI":"10.1016\/j.ccm.2020.06.007","article-title":"Definition, causes, pathogenesis, and consequences of chronic obstructive pulmonary disease exacerbations","volume":"41","author":"Ritchie","year":"2020","journal-title":"Clin Chest Med"},{"key":"R4-20260530","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1016\/S2213-2600(21)00511-7","article-title":"Global, regional, and national prevalence of, and risk factors for, chronic obstructive pulmonary disease (COPD) in 2019: A systematic review and modelling analysis","volume":"10","author":"Adeloye","year":"2022","journal-title":"The Lancet Respir Med"},{"key":"R5-20260530","doi-asserted-by":"crossref","first-page":"62","DOI":"10.4103\/abr.abr_134_19","article-title":"Comparison of nutritional behaviors and physical activities between overweight\/obese and normal-weight adults","volume":"8","author":"Babak","year":"2019","journal-title":"Adv Biomed Res"},{"key":"R6-20260530","first-page":"453","article-title":"Chronic obstructive pulmonary disease: Evaluation and management","volume":"103","author":"Duffy","year":"2019","journal-title":"Med Clin"},{"key":"R7-20260530","doi-asserted-by":"crossref","first-page":"e0255659","DOI":"10.1371\/journal.pone.0255659","article-title":"Reduction in hospitalised COPD exacerbations during COVID-19: A systematic review and meta-analysis","volume":"16","author":"Alqahtani","year":"2021","journal-title":"PLoS One"},{"key":"R8-20260530","doi-asserted-by":"crossref","first-page":"532","DOI":"10.1111\/resp.14041","article-title":"Chronic obstructive pulmonary disease exacerbation fundamentals: Diagnosis, treatment, prevention and disease impact","volume":"26","author":"MacLeod","year":"2021","journal-title":"Respirology"},{"key":"R9-20260530","doi-asserted-by":"crossref","first-page":"107227","DOI":"10.1016\/j.carpath.2020.107227","article-title":"Fatal pulmonary thromboembolism in SARS-CoV-2-infection","volume":"48","author":"Grimes","year":"2020","journal-title":"Cardiovasc Pathol"},{"key":"R10-20260530","doi-asserted-by":"crossref","first-page":"78","DOI":"10.5090\/kjtcs.2019.52.2.78","article-title":"Acute pulmonary thromboembolism: 14 years of surgical experience","volume":"52","author":"Park","year":"2019","journal-title":"Korean J Thorac Cardiovasc Surg"},{"key":"R11-20260530","first-page":"371","article-title":"Diagnostic Value of D-dimer in detecting pulmonary embolism in patients with acute COPD exacerbation","volume":"19","author":"Sadeghi","year":"2020","journal-title":"Tanaffos"},{"key":"R12-20260530","doi-asserted-by":"crossref","first-page":"1729","DOI":"10.2147\/COPD.S255414","article-title":"Clinical impact and healthcare resource utilization associated with early versus late COPD diagnosis in patients from UK CPRD database","author":"Kostikas","year":"2020","journal-title":"Int J Chron Obstruct Pulmon Dis"},{"key":"R13-20260530","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1164\/rccm.202009-3533SO","article-title":"Global initiative for the diagnosis, management, and prevention of chronic obstructive lung disease. The 2020 GOLD science committee report on COVID-19 and chronic obstructive pulmonary disease","volume":"203","author":"Halpin","year":"2021","journal-title":"Ame J Respir Crit Care Med"},{"key":"R14-20260530","doi-asserted-by":"crossref","first-page":"786","DOI":"10.1016\/S0140-6736(07)61382-8","article-title":"COPD exacerbations: Defining their cause and prevention","volume":"370","author":"Wedzicha","year":"2007","journal-title":"Lancet"},{"key":"R15-20260530","doi-asserted-by":"crossref","first-page":"1299","DOI":"10.2147\/COPD.S361929","article-title":"Fibrinogen, a promising marker to evaluate severity and prognosis of acute exacerbation of chronic obstructive pulmonary disease: A retrospective observational study","author":"Sun","year":"2022","journal-title":"Int J Chron Obstruct Pulmon Dis"},{"key":"R16-20260530","doi-asserted-by":"crossref","first-page":"1595","DOI":"10.2147\/COPD.S208245","article-title":"Comparison of clinical baseline characteristics between Asian and Western COPD patients in a prospective, international, multicenter study","volume":"14","author":"Kim","year":"2019","journal-title":"Int J Chron Obstruct Pulmon Dis"},{"key":"R17-20260530","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1016\/j.rmed.2018.01.019","article-title":"Evaluation of criteria for clinical control in a prospective, international, multicenter study of patients with COPD","volume":"136","author":"Miravitlles","year":"2018","journal-title":"Respir Med"},{"key":"R18-20260530","doi-asserted-by":"crossref","first-page":"293","DOI":"10.5045\/br.2021.2021131","article-title":"The demographic, clinical, and medical manifestations of pulmonary thromboembolism development in COVID-19","volume":"56","author":"Sadeghi","year":"2021","journal-title":"Blood Res"},{"key":"R19-20260530","doi-asserted-by":"crossref","first-page":"1732","DOI":"10.4103\/0366-6999.235865","article-title":"Pulmonary embolism in patients with acute exacerbation of chronic obstructive pulmonary disease","volume":"131","author":"Cao","year":"2018","journal-title":"Chin Med J"},{"key":"R20-20260530","doi-asserted-by":"crossref","first-page":"2785","DOI":"10.2147\/COPD.S119372","article-title":"Pulmonary complications after abdominal surgery in patients with mild-to-moderate chronic obstructive pulmonary disease","author":"Kim","year":"2016","journal-title":"Int J Chron Obstruct Pulmon Dis"}],"container-title":["Advanced Biomedical Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/abr.abr_219_24","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T15:18:20Z","timestamp":1787843900000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/abr.abr_219_24"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3]]},"references-count":20,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.4103\/abr.abr_219_24","relation":{},"ISSN":["2277-9175"],"issn-type":[{"value":"2277-9175","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3]]},"assertion":[{"value":"2024-05-11","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-01-18","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}