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Pulmonary Embolism Among Patients With Acute Exacerbation Of Chronic Obstructive Pulmonary Disease: Implications For Emergency Medicine.

by Mazer-Amirshahi, Maryann.
Citation: Journal of Emergency Medicine. 55(3):339-346, 2018 09..Journal: The Journal of emergency medicine.Published: 2018ISSN: 0736-4679.Full author list: Pourmand A; Robinson H; Mazer-Amirshahi M; Pines JM.UI/PMID: 29945817.Subject(s): *Emergency Service, Hospital | Humans | Prevalence | *Pulmonary Disease, Chronic Obstructive/co [Complications] | Pulmonary Embolism/ep [Epidemiology] | *Pulmonary Embolism/et [Etiology]Institution(s): MedStar Washington Hospital CenterDepartment(s): Emergency MedicineActivity type: Journal Article.Medline article type(s): Journal ArticleOnline resources: Click here to access online Digital Object Identifier: https://dx.doi.org/10.1016/j.jemermed.2018.05.026 (Click here) Abbreviated citation: J Emerg Med. 55(3):339-346, 2018 09.Local Holdings: Available online from MWHC library: 1995 - present, Available in print through MWHC library:1999-2007.Abstract: BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide. Common in COPD are acute exacerbations (AE-COPD) that cause acute dyspnea, cough, and bronchospasm. Symptoms of AE-COPD mimic pulmonary embolism (PE).Abstract: METHODS: We conducted a systematic review of the literature to assess the prevalence of PE in patients admitted to the hospital with a clinical diagnosis of AE-COPD. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines, we queried PubMed and MEDLINE databases from 1990 to 2017. The search term "prevalence pulmonary embolism, COPD" was used, and Boolean operators were used to combine search terms. Data were extracted from each article, specifically the sample size, study setting, design, and the prevalence of PE.Abstract: RESULTS: A total of 5 articles were included that demonstrated a prevalence of PE among patients with a clinical diagnosis of AE-COPD that ranged from 3.3-29.1%. Sample sizes varied from 49-197 patients. Studies occurred in both emergency department and inpatient settings, including intensive care units. Among the studies that reported patient characteristics associated with PE in AE-COPD, both obesity and immobility were important.Abstract: CONCLUSION: Studies reporting the prevalence of PE during AE-COPD vary considerably in their methods and results. Because of the relatively high prevalence of PE during AE-COPD, it is important for providers to be aware of this linkage between the 2 conditions and to screen patients using clinical gestalt and validated screening tools until more emergency department data are available.Abstract: Copyright (c) 2018 Elsevier Inc. All rights reserved.

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