Impact of Pulmonary Embolism on Acute Chronic Obstructive Pulmonary Disease Exacerbation
Yıl: 2017 Cilt: 28 Sayı: 3 Sayfa Aralığı: 168 - 170 Metin Dili: İngilizce DOI: 10.12996/gmj.2017.51 İndeks Tarihi: 10-04-2019
Impact of Pulmonary Embolism on Acute Chronic Obstructive Pulmonary Disease Exacerbation
Öz: Purpose: This study aims to assess effect of pulmonary embolism (PE) onclinical and laboratory parameters of patients hospitalized for acuteexacerbations of chronic obstructive pulmonary disease (AECOPD). Riskfactors for PE development were also evaluated.Methods: In this retrospective study, patients who were hospitalized forAECOPD and underwent computed tomographic pulmonary angiography scan(CTPA) between 2009 and 2011 were included. Patients with PE wereevaluated separately as those diagnosed at initial examination and thosesuspected during exacerbation therapy since they had inadequate response.Binary logistic regression analysis was used in order to determine risk factorson PE development.Results: The study consisted of 36 patients, 13 patients (36.1%) had PE. FEV1and FEV1/FVC values were higher in PE group (53.7% vs 41.4%; 62.3% vs 52%respectively; p<0.05). There was no difference between D-dimer levels of PEand non-PE patients. Risk of PE development did not differ with analyzedvariables. Those diagnosed at initial examination had significantly less numberof exacerbations in the last one year than those diagnosed during therapy (1.1vs 3.2; p<0.05).Conclusion: PE should always be considered in AECOPD etiology, particularlyin patients with frequent exacerbation history and D-dimer levels may bemisleading.
Anahtar Kelime: Pulmoner Emboli ve Akut Kronik Obstrüktif Akciğer Hastalığı Alevlenmesi Birlikteliği
Öz: Amaç: Bu çalışma ile kronik obstrüktif akciğer hastalığı akut alevlenmesi (KOAHA) nedeniyle hastane yatışı yapılan hastalarda tespit edilen pulmoner embolinin (PE), hastalığın klinik ve laboratuvar parametreleri üzerindeki etkisinin değerlendirilmesi amaçlanmıştır. PE gelişimine ait risk faktörleri ayrıca araştırılmıştır. Yöntem: Bu retrospektif çalışmaya 2009-2011 yılları arasında, KOAHA nedeni ile hastane yatışı yapılan ve bilgisayarlı tomografi pulmoner anjiyografi (BTPA) tetkiki bulunan hastalar dahil edilmiştir. PE tanısı alan hastalar ilk değerlendirme esnasında tanı alanlar ve tedavi sürecinde yetersiz klinik yanıt alınması nedeniyle araştırılırken tanı alanlar şeklinde ayrı ayrı değerlendirilmiştir. PE gelişimi için risk faktörlerinin belirlenmesi için ikili lojistik regresyon analizi kullanılmıştır. Bulgular: Çalışmaya alınan 36 hastanın 13’ünde (%36.1) PE mevcuttu. FEV1 ve FEV1/FVC değerleri PE grubunda daha yüksek bulundu (sırasıyla %53.7 vs %41.4; %62.3 vs %52; p<0.05). PE tespit edilen ve edilmeyen hastaların Ddimer seviyeleri arasında farklılık bulunmadı. Araştırılan parametrelerin PE gelişimi üzerinde etkisi tespit edilmedi. İlk değerlendirme esnasında PE tanısı alan hasta grubunun son 1 yıldaki atak sayısı takip esnasında tanı alan hastalara göre belirgin daha düşüktü (1.1 vs 3.2; p<0.05). Sonuçlar: Özellikle sık atak öyküsü bulunan KOAHA hastalarının etyolojisinde mutlaka PE varlığı araştırılmalıdır. Bu hasta grubundaki D-dimer sonuçlarının yanıltıcı olabileceği unutulmamalıdır.
Anahtar Kelime: Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
- Türk Toraks Derneği KOAH Çalışma Grubu. Kronik obstrüktif akciğer hastalığı (KOAH) koruma, tanı ve tedavi raporu. Turkish Thoracic Journal 2014: 15(Suppl 2).
- Lozano R, Naghavi M, Foreman K, Lim S, Shibuya K et al. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 2010; 380: 2095-128.
- Donaldson GC, Wedzicha JA. COPD exacerbations. 1: Epidemiology. Thorax 2006; 61: 164-8.
- Sapey E, Stockley RA. COPD exacerbations: 2. Aetiology. Thorax 2006; 61: 250-8.
- Tillie-Leblond I, Marquette CH, Perez T, Scherpereel A, Zanetti C et al. Pulmonary embolism in patients with unexplained exacerbation of chronic obstructive pulmonary disease: prevalence and risk factors. Ann Intern Med 2006; 144: 390-6.
- Chen WJ, Lin CC, Lin CY, Chang YJ, Sung FC et al. Pulmonary embolism in chronic obstructive pulmonary disease: a population-based cohort study. COPD 2014; 11: 438- 43.
- Rizkallah, J, Man SF, Sin DD. Prevalence of pulmonary embolism in acute exacerbations of COPD: a systematic review and metaanalysis. Chest 2009; 135: 786-93.
- Gunen H, Gulbas G, In E, Yetkin O, Hacievliyagil SS. Venous thromboemboli and exacerbations of COPD. Eur Respir J 2010; 35: 1243-8.
- Choi KJ, Cha SI, Shin KM, Lee J, Hwangbo Y et al. Prevalence and predictors of pulmonary embolism in Korean patients with exacerbation of chronic obstructive pulmonary disease. Respiration 2013; 85: 203-9.
- Akpinar EE, Hoşgün D, Akpinar S, Ataç GK, Doğanay B et al. Incidence of pulmonary embolism during COPD exacerbation. J Bras Pneumol 2014; 40: 38-45.
- Kamel, MM. Moussa H, Ismail A. Prevalence of venous thrombo-embolism in acute exacerbations of chronic obstructive pulmonary disease. Egypt J Chest Dis Tuberc 2013; 62: 557-66.
- Fernández C, Jiménez D, De Miguel J, Martí D, Díaz G et al. Chronic obstructive pulmonary disease in patients with acute symptomatic pulmonary embolism. Arch Bronconeumol 2009; 45: 286-90.
- Hasegawa W, Yamauchi Y, Yasunaga H, Sunohara M, Jo T et al. Factors affecting mortality following emergency admission for chronic obstructive pulmonary disease. BMC Pulm Med 2014; 14: 151.
- Bahloul M, Chaari A, Tounsi A, Baccouche N, Abid H et al. Incidence and impact outcome of pulmonary embolism in critically ill patients with severe exacerbation of chronic obstructive pulmonary diseases. Clin Respir J 2015; 9: 270-7.
- Arregui MA, Ezquerra KL, López FC, Lacasa RC. Hypercoagulability state and endotelial injury in stable chronic obstructive pulmonary disease patients. An Sist Sanit Navar 2010; 33: 43-50.
- Poulsen SH, Noer I, Møller JE, Knudsen TE, Frandsen JL. Clinical outcome of patients with suspected pulmonary embolism. A follow-up study of 588 consecutive patients. J Intern Med 2001; 250: 137-43.
- Roberts CM, Lowe D, Bucknall CE, Ryland I, Kelly Y et al. Clinical audit indicators of outcome following admission to hospital with acute exacerbation of chronic obstructive pulmonary disease. Thorax 2002; 57: 137-141.
- Wedzicha, JA, Hurst JR. Chronic obstructive pulmonary disease exacerbation and risk of pulmonary embolism. Thorax 2007; 62: 103-4.
| APA | Türk M, Yıldırım F, sevimli n, Kokturk N (2017). Impact of Pulmonary Embolism on Acute Chronic Obstructive Pulmonary Disease Exacerbation. , 168 - 170. 10.12996/gmj.2017.51 |
| Chicago | Türk Murat,Yıldırım Fatma,sevimli nurgül,Kokturk Nurdan Impact of Pulmonary Embolism on Acute Chronic Obstructive Pulmonary Disease Exacerbation. (2017): 168 - 170. 10.12996/gmj.2017.51 |
| MLA | Türk Murat,Yıldırım Fatma,sevimli nurgül,Kokturk Nurdan Impact of Pulmonary Embolism on Acute Chronic Obstructive Pulmonary Disease Exacerbation. , 2017, ss.168 - 170. 10.12996/gmj.2017.51 |
| AMA | Türk M,Yıldırım F,sevimli n,Kokturk N Impact of Pulmonary Embolism on Acute Chronic Obstructive Pulmonary Disease Exacerbation. . 2017; 168 - 170. 10.12996/gmj.2017.51 |
| Vancouver | Türk M,Yıldırım F,sevimli n,Kokturk N Impact of Pulmonary Embolism on Acute Chronic Obstructive Pulmonary Disease Exacerbation. . 2017; 168 - 170. 10.12996/gmj.2017.51 |
| IEEE | Türk M,Yıldırım F,sevimli n,Kokturk N "Impact of Pulmonary Embolism on Acute Chronic Obstructive Pulmonary Disease Exacerbation." , ss.168 - 170, 2017. 10.12996/gmj.2017.51 |
| ISNAD | Türk, Murat vd. "Impact of Pulmonary Embolism on Acute Chronic Obstructive Pulmonary Disease Exacerbation". (2017), 168-170. https://doi.org/10.12996/gmj.2017.51 |
| APA | Türk M, Yıldırım F, sevimli n, Kokturk N (2017). Impact of Pulmonary Embolism on Acute Chronic Obstructive Pulmonary Disease Exacerbation. Gazi Medical Journal, 28(3), 168 - 170. 10.12996/gmj.2017.51 |
| Chicago | Türk Murat,Yıldırım Fatma,sevimli nurgül,Kokturk Nurdan Impact of Pulmonary Embolism on Acute Chronic Obstructive Pulmonary Disease Exacerbation. Gazi Medical Journal 28, no.3 (2017): 168 - 170. 10.12996/gmj.2017.51 |
| MLA | Türk Murat,Yıldırım Fatma,sevimli nurgül,Kokturk Nurdan Impact of Pulmonary Embolism on Acute Chronic Obstructive Pulmonary Disease Exacerbation. Gazi Medical Journal, vol.28, no.3, 2017, ss.168 - 170. 10.12996/gmj.2017.51 |
| AMA | Türk M,Yıldırım F,sevimli n,Kokturk N Impact of Pulmonary Embolism on Acute Chronic Obstructive Pulmonary Disease Exacerbation. Gazi Medical Journal. 2017; 28(3): 168 - 170. 10.12996/gmj.2017.51 |
| Vancouver | Türk M,Yıldırım F,sevimli n,Kokturk N Impact of Pulmonary Embolism on Acute Chronic Obstructive Pulmonary Disease Exacerbation. Gazi Medical Journal. 2017; 28(3): 168 - 170. 10.12996/gmj.2017.51 |
| IEEE | Türk M,Yıldırım F,sevimli n,Kokturk N "Impact of Pulmonary Embolism on Acute Chronic Obstructive Pulmonary Disease Exacerbation." Gazi Medical Journal, 28, ss.168 - 170, 2017. 10.12996/gmj.2017.51 |
| ISNAD | Türk, Murat vd. "Impact of Pulmonary Embolism on Acute Chronic Obstructive Pulmonary Disease Exacerbation". Gazi Medical Journal 28/3 (2017), 168-170. https://doi.org/10.12996/gmj.2017.51 |
