The prevalence and clinical features of pulmonary embolism in patients with AE-COPD: A meta-analysis and systematic review.

The prevalence and clinical features of pulmonary embolism in patients with AE-COPD: A meta-analysis and systematic review.

<h4>Background</h4>The prevalence of pulmonary embolism (PE) in the acute exacerbation of chronic obstructive pulmonary disease (AE-COPD) is highly controversial. We conducted a systematic review and meta-analysis to summarize the epidemiology and characteristics of PE with AE-COPD for c...

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Autores principales: Xiaofang Fu, Yonghong Zhong, Wucheng Xu, Jiangang Ju, Min Yu, Minjie Ge, Xiaofei Gu, Qingqing Chen, Yibo Sun, Huaqiong Huang, Linfeng Shen
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Publicado: Public Library of Science (PLoS) 2021
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spelling oai:doaj.org-article:4cf0cca4c5644b6cbd66670cd8f66ece2021-12-02T20:08:38ZThe prevalence and clinical features of pulmonary embolism in patients with AE-COPD: A meta-analysis and systematic review.1932-620310.1371/journal.pone.0256480https://doaj.org/article/4cf0cca4c5644b6cbd66670cd8f66ece2021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0256480https://doaj.org/toc/1932-6203<h4>Background</h4>The prevalence of pulmonary embolism (PE) in the acute exacerbation of chronic obstructive pulmonary disease (AE-COPD) is highly controversial. We conducted a systematic review and meta-analysis to summarize the epidemiology and characteristics of PE with AE-COPD for current studies.<h4>Methods</h4>We searched the PubMed, EMBASE, Cochrane Library and Web of Science databases for studies published prior to October 21, 2020. Pooled proportions with 95% confidence intervals (95% CIs) were calculated using a random effects model. Odds ratios (ORs) and mean differences (MDs) with 95% confidence intervals were used as effect measures for dichotomous and continuous variables, respectively.<h4>Results</h4>A total of 17 studies involving 3170 patients were included. The prevalence of PE and deep vein thrombosis (DVT) in AE-COPD patients was 17.2% (95% CI: 13.4%-21.3%) and 7.1% (95% CI: 3.7%-11.4%%), respectively. Dyspnea (OR = 6.77, 95% CI: 1.97-23.22), pleuritic chest pain (OR = 3.25, 95% CI: 2.06-5.12), lower limb asymmetry or edema (OR = 2.46, 95% CI:1.51-4.00), higher heart rates (MD = 20.51, 95% CI: 4.95-36.08), longer hospital stays (MD = 3.66, 95% CI: 3.01-4.31) were associated with the PE in the AE-COPD patients. Levels of D-dimer (MD = 1.51, 95% CI: 0.80-2.23), WBC counts (MD = 1.42, 95% CI: 0.14-2.70) were significantly higher and levels of PaO2 was lower (MD = -17.20, 95% CI: -33.94- -0.45, P<0.05) in the AE-COPD with PE group. The AE-COPD with PE group had increased risk of fatal outcome than the AE-COPD group (OR = 2.23, 95% CI: 1.43-3.50).<h4>Conclusions</h4>The prevalence of PE during AE-COPD varies considerably among the studies. AE-COPD patients with PE experienced an increased risk of death, especially among the ICU patients. Understanding the potential risk factors for PE may help clinicians identify AE-COPD patients at increased risk of PE.<h4>Prospero registration number</h4>CRD42021226568.Xiaofang FuYonghong ZhongWucheng XuJiangang JuMin YuMinjie GeXiaofei GuQingqing ChenYibo SunHuaqiong HuangLinfeng ShenPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 9, p e0256480 (2021)
institution DOAJ
collection DOAJ
language EN
topic Medicine
R
Science
Q
spellingShingle Medicine
R
Science
Q
Xiaofang Fu
Yonghong Zhong
Wucheng Xu
Jiangang Ju
Min Yu
Minjie Ge
Xiaofei Gu
Qingqing Chen
Yibo Sun
Huaqiong Huang
Linfeng Shen
The prevalence and clinical features of pulmonary embolism in patients with AE-COPD: A meta-analysis and systematic review.
description <h4>Background</h4>The prevalence of pulmonary embolism (PE) in the acute exacerbation of chronic obstructive pulmonary disease (AE-COPD) is highly controversial. We conducted a systematic review and meta-analysis to summarize the epidemiology and characteristics of PE with AE-COPD for current studies.<h4>Methods</h4>We searched the PubMed, EMBASE, Cochrane Library and Web of Science databases for studies published prior to October 21, 2020. Pooled proportions with 95% confidence intervals (95% CIs) were calculated using a random effects model. Odds ratios (ORs) and mean differences (MDs) with 95% confidence intervals were used as effect measures for dichotomous and continuous variables, respectively.<h4>Results</h4>A total of 17 studies involving 3170 patients were included. The prevalence of PE and deep vein thrombosis (DVT) in AE-COPD patients was 17.2% (95% CI: 13.4%-21.3%) and 7.1% (95% CI: 3.7%-11.4%%), respectively. Dyspnea (OR = 6.77, 95% CI: 1.97-23.22), pleuritic chest pain (OR = 3.25, 95% CI: 2.06-5.12), lower limb asymmetry or edema (OR = 2.46, 95% CI:1.51-4.00), higher heart rates (MD = 20.51, 95% CI: 4.95-36.08), longer hospital stays (MD = 3.66, 95% CI: 3.01-4.31) were associated with the PE in the AE-COPD patients. Levels of D-dimer (MD = 1.51, 95% CI: 0.80-2.23), WBC counts (MD = 1.42, 95% CI: 0.14-2.70) were significantly higher and levels of PaO2 was lower (MD = -17.20, 95% CI: -33.94- -0.45, P<0.05) in the AE-COPD with PE group. The AE-COPD with PE group had increased risk of fatal outcome than the AE-COPD group (OR = 2.23, 95% CI: 1.43-3.50).<h4>Conclusions</h4>The prevalence of PE during AE-COPD varies considerably among the studies. AE-COPD patients with PE experienced an increased risk of death, especially among the ICU patients. Understanding the potential risk factors for PE may help clinicians identify AE-COPD patients at increased risk of PE.<h4>Prospero registration number</h4>CRD42021226568.
format article
author Xiaofang Fu
Yonghong Zhong
Wucheng Xu
Jiangang Ju
Min Yu
Minjie Ge
Xiaofei Gu
Qingqing Chen
Yibo Sun
Huaqiong Huang
Linfeng Shen
author_facet Xiaofang Fu
Yonghong Zhong
Wucheng Xu
Jiangang Ju
Min Yu
Minjie Ge
Xiaofei Gu
Qingqing Chen
Yibo Sun
Huaqiong Huang
Linfeng Shen
author_sort Xiaofang Fu
title The prevalence and clinical features of pulmonary embolism in patients with AE-COPD: A meta-analysis and systematic review.
title_short The prevalence and clinical features of pulmonary embolism in patients with AE-COPD: A meta-analysis and systematic review.
title_full The prevalence and clinical features of pulmonary embolism in patients with AE-COPD: A meta-analysis and systematic review.
title_fullStr The prevalence and clinical features of pulmonary embolism in patients with AE-COPD: A meta-analysis and systematic review.
title_full_unstemmed The prevalence and clinical features of pulmonary embolism in patients with AE-COPD: A meta-analysis and systematic review.
title_sort prevalence and clinical features of pulmonary embolism in patients with ae-copd: a meta-analysis and systematic review.
publisher Public Library of Science (PLoS)
publishDate 2021
url https://doaj.org/article/4cf0cca4c5644b6cbd66670cd8f66ece
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