Chronic obstructive pulmonary disease and deep vein thrombosis: a prevalent combination

Background Patients with chronic obstructive pulmonary disease (COPD) are at increased risk for venous thromboembolism (VTE). We analyzed a large US deep vein thrombosis (DVT) registry to explore the profile of patients with COPD and VTE. Methods Demographics, symptoms, risk factors, prophylaxis, and initial management of 668 (12%) patients with COPD were compared to 3,907 patients without COPD from a prospective registry of 5,451 consecutive patients with ultrasound-confirmed DVT at 183 institutions in the United States. Results COPD patients with DVT were older (median 72.5 years vs. 68.0 years, P < 0.0001) and more likely to be male (52.3% vs. 44.8%, P = 0.0004). They were more likely to be inpatients at the time of diagnosis of DVT (62.0% vs. 51.9%, P < 0.0001). COPD patients were more likely to be admitted to the Intensive Care Unit (ICU) (27.7% vs.19.8%, P = 0.0003), more likely to require mechanical ventilation (23.2% vs. 13.6%, P < 0.0001), and more likely to receive inferior vena caval (IVC) filters (19.1% vs. 15.1%, P = 0.009). COPD patients more often had concomitant pulmonary embolism (PE) (22.8% vs.17.8%, P = 0.005) as well as concomitant congestive heart failure (29.5% vs. 12.5%, P < 0.0001). Conclusions DVT patients with COPD have a greater medical acuity than other DVT patients. This results in more frequent IVC filter insertion.