Frequency of Pulmonary Embolism in Patients with COPD Exacerbation and Clinical and Laboratory Predictive Factors

Abstract Background: 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. Materials and Methods: 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. Results: 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 ( P < 0.001 for all). Conclusion: 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.