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Pulmonary embolism and mortality in patients with COPD
J L Carson1, M L Terrin, A Duff
1Department of Medicine, University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School, New Brunswick 08903, USA.
Chest
|November 1, 1996
Summary
Pulmonary embolism (PE) significantly increases mortality risk in patients with chronic obstructive pulmonary disease (COPD). This study highlights the critical need for further research into the elevated mortality observed in COPD patients with PE.
Area of Science:
- Pulmonary and Critical Care Medicine
- Cardiovascular Research
- Epidemiology
Background:
- Pulmonary embolism (PE) is often considered a secondary cause of death, with underlying conditions being primary.
- The impact of PE on mortality across diverse patient populations with specific diseases remains unclear.
Purpose of the Study:
- To investigate the association between pulmonary embolism and mortality rates in patients with varying underlying diseases.
- Specifically, to determine if PE exacerbates mortality in patients with chronic obstructive pulmonary disease (COPD).
Main Methods:
- A cohort of 1,487 patients undergoing lung scans for PE diagnosis was assessed.
- Mortality was prospectively reviewed up to 1 year post-enrollment by an outcome classification committee.
Main Results:
- Overall 1-year mortality was 23.8% for patients with PE versus 18.9% without PE (relative risk, 1.34).
- A significant interaction (p=0.03) was observed between PE status and COPD, indicating differential mortality.
- Patients with both COPD and PE faced a 1.94-fold increased risk of 1-year mortality compared to those without PE, with 53.3% mortality in this subgroup.
Conclusions:
- Patients diagnosed with both COPD and pulmonary embolism exhibit a notably higher 1-year mortality rate.
- Further investigation is warranted to elucidate the specific factors contributing to this increased mortality risk.