Risk Factors Of Venous Thromboembolism Among Patients With Acute Exacerbation Of Chronic Obstructive Pulmonary Disease

Objective: To explore the risk factors of venous thromboembolism(VTE)among patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods: Based on a prospective,multi-center study,16 hospitals participated.COPD patients who admitted to hospitals because of acute exacerbation were included in the study consecutively.Basic data,clinical features,clinical examinations were collected.Logistic multivariate regression analysis was conducted.Adjustment variables include age,lower limb venous disease history,using of diuretics,syncope,lower limb symptoms,fever,coagulation indexes.Result: Totally 1123 patients were included.The incidence of VTE among AECOPD patients was 6.9%(78/1123).Compared with non-VTE group,VTE group were older,having more history of venous thrombosis and varicosity in lower extremity,immobilization for 3 days or more,using diuretic,syncope,swelling in lower limbs,trouble in walking,pain or tenderness in lower limbs,fever after in hospital,D-dimer higher,Hb lower.All the differences between the two groups were statistically significant(P<0.05).Logistic multivariate regression analysis showed that there were differences between two groups after adjusting covariates.Venous thrombosis history,immobilization for 3 days or more,unilateral lower limb pain or tenderness or bilateral lower limb pain or tenderness before in hospital,higher D-dimer were risk factors for VTE among AECOPD patients(P<0.05),OR were 16.4(95% CI: 7.7,35.0),2.2(95% CI: 1.1,4.3),10.0(95% CI: 2.5,40.0),7.6(95% CI: 2.4,23.8),1.4(95% CI: 1.1,1.7)respectively.Conclusion: The incidence of VTE in patients with acute exacerbation of chronic obstructive pulmonary disease is high.It is necessary for clinicians to pay more attention to patients who have venous thrombosis history,immobilization for 3 days or more,lower limb pain or tenderness before in hospital,D-dimer higher,dehydration or using diuretics.Those patients have a potential risk of venous thrombosis,conventional anticoagulant therapy may be considered.It will not increase the risk of venous thrombosis that using glucocorticoids in AECOPD patients.