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).
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.
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.
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.
Keywords
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Article info
Publication history
Published online: June 23, 2018
Accepted:
May 30,
2018
Received in revised form:
May 1,
2018
Received:
February 7,
2018
Footnotes
Reprints are not available from the authors.
Identification
Copyright
© 2018 Elsevier Inc. All rights reserved.
