Prevalence of pulmonary embolism in patients with acute exacerbation of chronic obstructive pulmonary disease.

Background Patients suffering from chronic obstructive pulmonary disease (COPD) are often admitted to hospital with an exacerbation of their disease, these episodes are most often attributed to an acute exacerbation of bronchial infection but the real cause is often unknown. COPD is considered a risk factor for pulmonary embolism (PE) and PE is part of the differential diagnosis of an acute exacerbation of COPD. Our aim was to detect the prevalence of pulmonary embolism in patients of COPD presenting with acute exacerbation of their disease. Methods Prospective randomized, clinical trial performed in 25 patients with COPD presenting with acute exacerbation of their disease Patients were categorized into two groups (Group A) patients without multislice CT pulmonary angiography findings of pulmonary embolism.(Group B) patients with multislice CT pulmonary angiography findings of pulmonary embolism. The patients of the two groups compared for duration of hospitalization, Use of mechanical ventilation and duration of mechanical ventilation. Results All studied patients were evaluated by SOFA score which ranged from 2 to 4 in all patients with a mean of 2.6 ± 0.6, while in patients with pulmonary embolism it ranged from 3 to 4 with a mean of 3.3±0.6. The duration of hospital stay in all studied patients ranged from 12 to 20 days with a mean of 9.4±3.5, while the 3 patients with pulmonary embolism stayed in hospital for 12 days each. Seventy eight percent of all studied patients (n=21) were mechanically ventilated while 22% (n=6) were not. Concerning patients with pulmonary embolism (n=3), two patients were mechanically ventilated while the other patient was not. CONCLUSIONS This study showed an 11% prevalence of PE in patients with COPD admitted for severe exacerbation of unknown origin and complicated by respiratory failure.