Exacerbations of chronic obstructive pulmonary disease: An Indian perspective.

ABSTRACT

Background. Chronic obstructive pulmonary disease (COPD) will be the third leading cause of death by 2020. Recent studies reveal that pulmonary embolism (PE) may be a trigger of acute deterioration in patients with COPD. Patients with COPD have approximately twice the risk of PE than those without COPD. Objective. The primary objective was to assess the prevalence of venous thromboembolism (VTE) in patients with acute exacerbation of COPD (AE-COPD) in India. Methods. We conducted this prospective study on patients admitted for AE-COPD in a tertiary care hospital in Mumbai, India. We considered the prevalence of deep venous thrombosis (DVT) to reflect the occurrence of VTE. The screening tool used was a colour Doppler of the bilateral lower limbs. Results. One hundred patients enrolled, were in stage II to stage IV COPD; 9% had DVT. Eight of these nine patients had unilateral DVT. Two patients had developed PE and died. Conclusions. Our results show a lower prevalence of unsuspected DVT in Indian patients admitted for AE-COPD. Future prospective, randomised studies are needed to confirm the findings of the present study and to determine whether a systematic evaluation for VTE is justified in these patients, and hence, be recommended.