Clinical characteristics, clinical laboratories, and risk factors of elderly patients with chronic obstructive pulmonary disease complicated with pulmonary embolism

Abstract

Purpose: The objective of this research is to examine the occurrence, clinical manifestations, and determinants of pulmonary embolism (PE) in older individuals diagnosed with chronic obstructive pulmonary disease (COPD). Methods: A retrospective analysis was performed on elderly patients diagnosed with COPD, who were admitted to five different hospitals within our province. These patients were categorized into two groups based on the presence or absence of pulmonary embolism (PE). And systematically compile and examine the foundational data, clinical attributes, and pertinent laboratory parameters outlined in their respective medical records. These encompass blood routine, arterial blood gas analysis, coagulation markers, and biochemical indicators. Results: A total of 958 elderly patients with COPD were included in the study. Among them, 121 patients (12.63%) were found to have complications with PE. During hospitalization, 50 cases (5.22%) resulted in death. In the multivariate analysis, several factors were found to be significantly associated with a higher prevalence of PE, including age, female gender, deep vein thrombosis, hypertension, PaCO2 ≤ 40 mmHg, and normal clinical signs and symptoms on chest X-rays (p < 0.05). The RDW-SD and RDW-CV values of the COPD combined with the PE group were significantly higher compared to those of the COPD without PE group (p < 0.001). The risk of PE caused by higher RDW-SD was significantly greater than that caused by lower RDW-SD (p < 0.05). The area under the curve for RDW-SD in predicting PE is 0.723. The critical value of RDW-SD was determined to be 46.25, with a sensitivity of 75.59% and a specificity of 67.5%. Conclusion: It is essential to give careful attention to the prevalence and factors that put elderly patients with COPD at risk for PE. The utilization of RDW could potentially serve as a predictive tool for identifying the onset of PE in COPD patients.