Objective： In most cotintries, nearly 6% of the adults are suffering from chronic obstructive pulmonary disease （COPD）. which puts a huge economic burden on the society. Moreover, COPD has been considered as an ind...Objective： In most cotintries, nearly 6% of the adults are suffering from chronic obstructive pulmonary disease （COPD）. which puts a huge economic burden on the society. Moreover, COPD has been considered as an independent risk factor for pulmonary embolism （PE）. In this review, we summarized the existing evidence that demonstrates the associations between COPD exacerbation and PE from various aspects, including epidemiology, pathophysiological changes, risk factors, clinical features, management, and prognosis. Data Sources： We searched the terms ＂chronic obstructive pulmonary disease,＂ ＂＇pulmonary embolism,＂ ＂exacerbations,＂ and ＂＇thromboembolic＂ in PubMed database and collected the results up to April 2018. The language was limited to English. Study Selection： We thoroughly examined the titles and abstracts of all studies that met our search strategy. The data from prospective studies, meta-analyses, retrospective studies, and recent reviews were selected for preparing this review. Results： The prevalence of PE in patients with COPD exacerbation varied a lot among different studies, mainly due to the variations in race, sample size, study design, research setting, and enrollment criteria. Overall, whites and African Americans showed significantly higher prevalence of PE than Asian people, and the hospitalized patients showed higher prevalence of PE compared to those who were evaluated in emergency department. PE is easily overlooked in patients with COPD exacerbation due to the similar clinical symptoms. However, several factors have been identified to contribute to the increased risk of PE during COPD exacerbation. Obesity and lower limb asymmetry were described as independent predictors for PE. Moreover, due to the high risk of PE, thromboprophylaxis has been used as an important treatment for hospitalized patients with COPD exacerbation. Conclusions： According to the previous studies, COPD patients with PE experienced an increased risk of death and prolonged length of h展开更多
Background As the third most frequent cardiovascular disease, venous thromboembolism （VTE） remains a major cause of morbidity and mortality in hospitalized patients. The aim of this study was to determine the incide...Background As the third most frequent cardiovascular disease, venous thromboembolism （VTE） remains a major cause of morbidity and mortality in hospitalized patients. The aim of this study was to determine the incidence of VTE and steps for its prevention in acutely ill hospitalized elderly Chinese patients.Methods A prospective multi-center study was conducted from June 2006 to November 2007. A total of 607 patientsfrom 40 research centers in China were enrolled. Data of the patients＇ baseline characteristics, VTE events and prophylaxis/therapy methods were collected.Results Fifty-nine patients （9.7%） had an objectively confirmed VTE during the 90-day follow-up, of which, 59.3%occurred during the first week and 75% within 14 days. Forty-one patients died （6.6%） during the follow-up, 36.6% died within three weeks. We also found that medical disorders including respiratory failure （16.4%）, acute brain infarction （15.6%）, acute infectious diseases （14.3%）, acute coronary artery syndrome （8.7%） and heart failure （7.6%） play a role in provoking VTE. Only 13.0% of the elderly patients with high risk of VTE used low dose unfractionated heparin, 7.1% used low molecular weight heparin, 5.4% used warfarin,0.3% used graduated compression stockings and none of them used intermittent pneumatic compression.Conclusions Our study showed similar results between our study and western countries in the VTE incidence by day 90 in elderly hospitalized patients with acute medical illness. Great caution must be applied in the care of acutely ill elderly hospitalized patients to deal with the complications of VTE. Application of safe and effective prophylaxes against embolism remains a critical challenge.展开更多
Background： No data on the incidence ofpleural effusion （PE） in Chinese patients with pulmonary embolism are available to date. The aim of the current study was to investigate the frequency of PE in a Chinese popul...Background： No data on the incidence ofpleural effusion （PE） in Chinese patients with pulmonary embolism are available to date. The aim of the current study was to investigate the frequency of PE in a Chinese population of patients with pulmonary embolism. Methods： This was a retrospective observational single-center study. All data of computed tomography pulmonary angiography （CTPA） performed over 6-year period on adult patients with clinically suspected pulmonary embolism were analyzed. Results： From January 2008 until December 2013, PE was identified in 423 of 3141 patients （13.5%） with clinically suspected pulmonary embolism who underwent CTPA, The incidence of PE in patients with pulmonary embolism （19.9%） was significantly higher than in those without embolism （9.4%） （P 〈 0.001 ）. Majority of PEs in pulmonary embolism patients were small to moderate and were unilateral. The locations of emboli and the numbers of arteries involved, CT pulmonary obstruction index, and parenchymal abnormalities at CT were not associated with the development of PE, Conclusions： PEs are present in about one fifth of a Chinese population of patients with pulmonary embolism, which are usually small, unilateral, and unsuitable for diagnostic thoracentesis.展开更多
文摘Objective： In most cotintries, nearly 6% of the adults are suffering from chronic obstructive pulmonary disease （COPD）. which puts a huge economic burden on the society. Moreover, COPD has been considered as an independent risk factor for pulmonary embolism （PE）. In this review, we summarized the existing evidence that demonstrates the associations between COPD exacerbation and PE from various aspects, including epidemiology, pathophysiological changes, risk factors, clinical features, management, and prognosis. Data Sources： We searched the terms ＂chronic obstructive pulmonary disease,＂ ＂＇pulmonary embolism,＂ ＂exacerbations,＂ and ＂＇thromboembolic＂ in PubMed database and collected the results up to April 2018. The language was limited to English. Study Selection： We thoroughly examined the titles and abstracts of all studies that met our search strategy. The data from prospective studies, meta-analyses, retrospective studies, and recent reviews were selected for preparing this review. Results： The prevalence of PE in patients with COPD exacerbation varied a lot among different studies, mainly due to the variations in race, sample size, study design, research setting, and enrollment criteria. Overall, whites and African Americans showed significantly higher prevalence of PE than Asian people, and the hospitalized patients showed higher prevalence of PE compared to those who were evaluated in emergency department. PE is easily overlooked in patients with COPD exacerbation due to the similar clinical symptoms. However, several factors have been identified to contribute to the increased risk of PE during COPD exacerbation. Obesity and lower limb asymmetry were described as independent predictors for PE. Moreover, due to the high risk of PE, thromboprophylaxis has been used as an important treatment for hospitalized patients with COPD exacerbation. Conclusions： According to the previous studies, COPD patients with PE experienced an increased risk of death and prolonged length of h
文摘Background As the third most frequent cardiovascular disease, venous thromboembolism （VTE） remains a major cause of morbidity and mortality in hospitalized patients. The aim of this study was to determine the incidence of VTE and steps for its prevention in acutely ill hospitalized elderly Chinese patients.Methods A prospective multi-center study was conducted from June 2006 to November 2007. A total of 607 patientsfrom 40 research centers in China were enrolled. Data of the patients＇ baseline characteristics, VTE events and prophylaxis/therapy methods were collected.Results Fifty-nine patients （9.7%） had an objectively confirmed VTE during the 90-day follow-up, of which, 59.3%occurred during the first week and 75% within 14 days. Forty-one patients died （6.6%） during the follow-up, 36.6% died within three weeks. We also found that medical disorders including respiratory failure （16.4%）, acute brain infarction （15.6%）, acute infectious diseases （14.3%）, acute coronary artery syndrome （8.7%） and heart failure （7.6%） play a role in provoking VTE. Only 13.0% of the elderly patients with high risk of VTE used low dose unfractionated heparin, 7.1% used low molecular weight heparin, 5.4% used warfarin,0.3% used graduated compression stockings and none of them used intermittent pneumatic compression.Conclusions Our study showed similar results between our study and western countries in the VTE incidence by day 90 in elderly hospitalized patients with acute medical illness. Great caution must be applied in the care of acutely ill elderly hospitalized patients to deal with the complications of VTE. Application of safe and effective prophylaxes against embolism remains a critical challenge.
基金This work was supported in part by grants from National Natural Science Foundation of China，from the High-Level Technical Personnel Training Project of Beijing Municipal Health System,China
文摘Background： No data on the incidence ofpleural effusion （PE） in Chinese patients with pulmonary embolism are available to date. The aim of the current study was to investigate the frequency of PE in a Chinese population of patients with pulmonary embolism. Methods： This was a retrospective observational single-center study. All data of computed tomography pulmonary angiography （CTPA） performed over 6-year period on adult patients with clinically suspected pulmonary embolism were analyzed. Results： From January 2008 until December 2013, PE was identified in 423 of 3141 patients （13.5%） with clinically suspected pulmonary embolism who underwent CTPA, The incidence of PE in patients with pulmonary embolism （19.9%） was significantly higher than in those without embolism （9.4%） （P 〈 0.001 ）. Majority of PEs in pulmonary embolism patients were small to moderate and were unilateral. The locations of emboli and the numbers of arteries involved, CT pulmonary obstruction index, and parenchymal abnormalities at CT were not associated with the development of PE, Conclusions： PEs are present in about one fifth of a Chinese population of patients with pulmonary embolism, which are usually small, unilateral, and unsuitable for diagnostic thoracentesis.
