The prevalence and risk factors of pulmonary embolism in patients with chronic obstructive pulmonary disease: a systematic review and meta-analysis
Abstract Background An increased prevalence of PE has been found in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD). Early identification of risk factors for the development of PE in patients with AECOPD and intervention is important. Therefore, we comprehensively p...
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2025-04-01
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| Series: | Thrombosis Journal |
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| Online Access: | https://doi.org/10.1186/s12959-025-00728-6 |
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| author | Mingzhu Li Yeqian Jiang Ying Xu Qianbing Li |
| author_facet | Mingzhu Li Yeqian Jiang Ying Xu Qianbing Li |
| author_sort | Mingzhu Li |
| collection | DOAJ |
| description | Abstract Background An increased prevalence of PE has been found in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD). Early identification of risk factors for the development of PE in patients with AECOPD and intervention is important. Therefore, we comprehensively pool and analyze the prevalence and risk factors of PE among patients experiencing AECOPD, aiming to provide valuable insights for clinical-based diagnostic determination and prevention of PE in the AECOPD patient population. Methods A systematic literature search was conducted for studies reporting the incidence and risk factors for PE in patients with AECOPD. Study quality was assessed using the modified Newcastle-Ottawa Quality Assessment Scale. The degree of heterogeneity was assessed by the I2 statistic. The publication bias (studies ≥ 10) was evaluated using Egger’s test. Results Among the 1421 studies initially retrieved, 22 articles were ultimately selected and incorporated into the analysis. Based on the meta-analysis and the review’s updated findings, the prevalence of PE in AECOPD is 17.82% (95% CI 12.72%-23.57%, P<0.001). The following factors were identified as risk factors for PE among patients with AECOPD: age(weighted mean difference [WMD] 2.0119, 95% CI 0.7126–3.3133, I 2 = 51.8%, P = 0.02), males(odds ratio [OR] 0.9528, 95% CI 0.6869–1.3216, I 2 = 65.0%, P<0.001), obesity(OR 1.3086, 95% CI 0.1895–9.0385, I 2 = 74.5%, P = 0.02), malignant disease(OR 1.5902, 95%CI 0.9689–2.6097, I 2 = 54.7%, P = 0.03), hypertension(OR 1.0663, 95%CI 0.7920–1.4355, I 2 = 57.7%, P = 0.009), immobilization ≥ 3d(OR 3.9158, 95% CI 1.0925–14.0354, I 2 = 91.6%, P<0.001), edema of lower limb(OR 2.1558, 95% CI 1.3365–3.4773, I 2 = 75.4%, P<0.001), pulmonary hypertension(OR 1.3146, 95%CI 0.7481-2.3100, I 2 = 70.1%, P = 0.04), cough(OR 0.7084, 95%CI 0.1304–3.8497, I 2 = 88.8%, P<0.001), purulent sputum(OR 0.7570, 95%CI 0.4005–1.4309, I 2 = 61.9%, P = 0.049), and D-dimer(WMD 0.8619, 95%CI 0.0449–1.6789, I 2 = 91.4%, P<0.001), C-reactive protein(CRP)(WMD 0.8852, 95%CI -4.0639-5.8344, I 2 = 76.4%, P = 0.005) or fibrinogen(WMD 0.8663, 95%CI -0.2572-1.9898, I 2 = 92.2%, P<0.001) levels. Clinical risk factors(including S1Q3 pattern on electrocardiograph(ECG), hospital stay and home oxygen therapy) showed no significant association with the occurrence of PE (P>0.05). Conclusions This updated meta-analysis and systematic review revealed that the prevalence of pulmonary embolism in the AECOPD was 17.82%. This figure may vary depending on how the diagnostic procedure is carried out. Age, males, obesity, malignant disease, hypertension, immobilization ≥ 3d, edema of lower limb, pulmonary hypertension, cough, purulent sputum, and D-dimer, CRP or fibrinogen level may serve as potential risk factors for PE among patients with AECOPD. |
| format | Article |
| id | doaj-art-aff815703c7043b99ec729a7fa5ae496 |
| institution | DOAJ |
| issn | 1477-9560 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | BMC |
| record_format | Article |
| series | Thrombosis Journal |
| spelling | doaj-art-aff815703c7043b99ec729a7fa5ae4962025-08-20T02:55:23ZengBMCThrombosis Journal1477-95602025-04-0123111610.1186/s12959-025-00728-6The prevalence and risk factors of pulmonary embolism in patients with chronic obstructive pulmonary disease: a systematic review and meta-analysisMingzhu Li0Yeqian Jiang1Ying Xu2Qianbing Li3Department of Respiratory and Critical Care Medicine, Anqing First People’s Hospital of Anhui Medical UniversityDepartment of Respiratory and Critical Care Medicine, Anqing First People’s Hospital of Anhui Medical UniversityDepartment of Respiratory and Critical Care Medicine, Anqing First People’s Hospital of Anhui Medical UniversityDepartment of Respiratory and Critical Care Medicine, Anqing First People’s Hospital of Anhui Medical UniversityAbstract Background An increased prevalence of PE has been found in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD). Early identification of risk factors for the development of PE in patients with AECOPD and intervention is important. Therefore, we comprehensively pool and analyze the prevalence and risk factors of PE among patients experiencing AECOPD, aiming to provide valuable insights for clinical-based diagnostic determination and prevention of PE in the AECOPD patient population. Methods A systematic literature search was conducted for studies reporting the incidence and risk factors for PE in patients with AECOPD. Study quality was assessed using the modified Newcastle-Ottawa Quality Assessment Scale. The degree of heterogeneity was assessed by the I2 statistic. The publication bias (studies ≥ 10) was evaluated using Egger’s test. Results Among the 1421 studies initially retrieved, 22 articles were ultimately selected and incorporated into the analysis. Based on the meta-analysis and the review’s updated findings, the prevalence of PE in AECOPD is 17.82% (95% CI 12.72%-23.57%, P<0.001). The following factors were identified as risk factors for PE among patients with AECOPD: age(weighted mean difference [WMD] 2.0119, 95% CI 0.7126–3.3133, I 2 = 51.8%, P = 0.02), males(odds ratio [OR] 0.9528, 95% CI 0.6869–1.3216, I 2 = 65.0%, P<0.001), obesity(OR 1.3086, 95% CI 0.1895–9.0385, I 2 = 74.5%, P = 0.02), malignant disease(OR 1.5902, 95%CI 0.9689–2.6097, I 2 = 54.7%, P = 0.03), hypertension(OR 1.0663, 95%CI 0.7920–1.4355, I 2 = 57.7%, P = 0.009), immobilization ≥ 3d(OR 3.9158, 95% CI 1.0925–14.0354, I 2 = 91.6%, P<0.001), edema of lower limb(OR 2.1558, 95% CI 1.3365–3.4773, I 2 = 75.4%, P<0.001), pulmonary hypertension(OR 1.3146, 95%CI 0.7481-2.3100, I 2 = 70.1%, P = 0.04), cough(OR 0.7084, 95%CI 0.1304–3.8497, I 2 = 88.8%, P<0.001), purulent sputum(OR 0.7570, 95%CI 0.4005–1.4309, I 2 = 61.9%, P = 0.049), and D-dimer(WMD 0.8619, 95%CI 0.0449–1.6789, I 2 = 91.4%, P<0.001), C-reactive protein(CRP)(WMD 0.8852, 95%CI -4.0639-5.8344, I 2 = 76.4%, P = 0.005) or fibrinogen(WMD 0.8663, 95%CI -0.2572-1.9898, I 2 = 92.2%, P<0.001) levels. Clinical risk factors(including S1Q3 pattern on electrocardiograph(ECG), hospital stay and home oxygen therapy) showed no significant association with the occurrence of PE (P>0.05). Conclusions This updated meta-analysis and systematic review revealed that the prevalence of pulmonary embolism in the AECOPD was 17.82%. This figure may vary depending on how the diagnostic procedure is carried out. Age, males, obesity, malignant disease, hypertension, immobilization ≥ 3d, edema of lower limb, pulmonary hypertension, cough, purulent sputum, and D-dimer, CRP or fibrinogen level may serve as potential risk factors for PE among patients with AECOPD.https://doi.org/10.1186/s12959-025-00728-6Pulmonary embolismChronic obstructive pulmonary diseaseAcute exacerbationPrevalenceRisk factors |
| spellingShingle | Mingzhu Li Yeqian Jiang Ying Xu Qianbing Li The prevalence and risk factors of pulmonary embolism in patients with chronic obstructive pulmonary disease: a systematic review and meta-analysis Thrombosis Journal Pulmonary embolism Chronic obstructive pulmonary disease Acute exacerbation Prevalence Risk factors |
| title | The prevalence and risk factors of pulmonary embolism in patients with chronic obstructive pulmonary disease: a systematic review and meta-analysis |
| title_full | The prevalence and risk factors of pulmonary embolism in patients with chronic obstructive pulmonary disease: a systematic review and meta-analysis |
| title_fullStr | The prevalence and risk factors of pulmonary embolism in patients with chronic obstructive pulmonary disease: a systematic review and meta-analysis |
| title_full_unstemmed | The prevalence and risk factors of pulmonary embolism in patients with chronic obstructive pulmonary disease: a systematic review and meta-analysis |
| title_short | The prevalence and risk factors of pulmonary embolism in patients with chronic obstructive pulmonary disease: a systematic review and meta-analysis |
| title_sort | prevalence and risk factors of pulmonary embolism in patients with chronic obstructive pulmonary disease a systematic review and meta analysis |
| topic | Pulmonary embolism Chronic obstructive pulmonary disease Acute exacerbation Prevalence Risk factors |
| url | https://doi.org/10.1186/s12959-025-00728-6 |
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