A study assessed the effect of a pulmonary embolism (PE) diagnostic strategy on clinical outcomes in patients hospitalized with chronic obstructive pulmonary disease (COPD).
This randomized clinical trial was conducted across 18 hospitals in Spain. The study comprised a total of 746 patients who were randomized from September 2014 to July 2020 to either usual care plus an active strategy for diagnosing PE (n=370), or usual care (n=367). The primary outcome was defined as composite of nonfatal symptomatic venous thromboembolism (VTE), readmission for COPD, or death within 90 days after randomization. The secondary outcomes were nonfatal new or recurrent VTE, readmission for COPD, and death from any cause within 90 days.
According to the results, the primary outcome occurred in 29.7% of patients in the intervention group and 29.2% in the control group. The researchers observed that new or recurrent VTE was not significantly different between the two groups (0.5% vs. 2.5%; risk difference, -2.0%). By day 90, approximately 25% of patients in the intervention group and almost 23.0% in the control group had been readmitted for exacerbation of COPD (risk difference, 2.5% ). Death from any cause occurred in just over 6.0% in the intervention group and almost 8.0% in the control group.
“Among patients hospitalized for an exacerbation of COPD, the addition of an active strategy for the diagnosis of PE to usual care, compared with usual care alone, did not significantly improve a composite health outcome,” the researchers concluded. They added that study “may not have had adequate power to assess individual components of the composite outcome.”
Keywords: COPD, venous thromboembolism