GUO Lu 1 , YANG Yang 1 , JIANG Hongli 2 , GONG Daoming 3 , GAO Lingyun 4 , YANG Yan 1 , ZHANG Jing 1 , ZHONG Tian 1 , LIU Yuejian 1 , JIE Zhengliang 1
  • 1. Department of Respiratory and Critical Care Medicine, Sichuan Academy of Medical Science, Sichuan Provincial People’s Hospital, University Hospital of Electronic Science & Technology of China, Chengdu, Sichuan 610072, P. R. China;
  • 2. Pneumology Group, Department of Integrated Traditional Chinese and Western Medicine, West China Hospital of Sichuan University, Chengdu, Sichuan 610041, P. R. China;
  • 3. Department of Respiratory Medicine, Ziyang People’s Hospital, Ziyang, Sichuan 641300, P. R. China;
  • 4. Department of Respiratory Medicine, Division of East Ward, Sichuan Academy of Medical Sciences, Sichuan Provincial People’s Hospital, University Hospital of Electronic Science & Technology of China, Chengdu, Sichuan 610101, P. R. China;
GUO Lu, Email: guoluhx@med.uestc.edu.cn
Chronic obstructive pulmonary disease; Pulmonary embolism; Thrombocytosis; Pulmonary hypertension; Mortality
10.7507/1671-6205.201708041
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Objective  To explore the relationship between thrombocytosis and all-cause in-hospital mortality in patients with chronic obstructive pulmonary disease (COPD) and low-risk pulmonary embolism (PE). Methods  In a multicenter retrospective study on clinical characteristics, COPD patients with proven acute PE between October 2005 and February 2017 were enrolled. The patients in risk classes III-V on the basis of the PESI score were excluded. The patients with COPD and low-risk PE were divided into two groups of those with thrombocytosis and without thrombocytosis after extracting platelet count on admission. The clinical characteristics and prognosis of the two groups were compared. Multivariate logistic regression was performed to reveal an association between thrombocytosis and all-cause in-hospital mortality after confounding variables were adjusted. Results  A total of 874 consecutive patients with COPD and PE at low risk were enrolled in which 191 (21.9%) with thrombocytosis. Compared with those without thrombocytosis, the thrombocytopenic group had significantly lower body mass index [(20.9±3.3) kg/m2 vs. (25.1±3.8) kg/m2, P=0.01], lower levels of forced expiratory volume in one second (FEV1) [(0.9±0.4) L vs. (1.3±0.3) L, P=0.001] and lower partial pressure of oxygen in the arterial blood (PaO2) [(7.8±1.2) kPa vs. (9.7±2.3) kPa, P=0.003]. The COPD patients with thrombocytosis had a higher proportion of cardiovascular complications as well as higher level of systolic pulmonary arterial pressure (sPAP) [(46.5±20.6) mm Hg vs. (34.1±12.6) mm Hg, P=0.001]. Multivariate logistic regression analysis after adjustment for confounders revealed that thrombocytosis was associated with all-cause mortality in hospitalized patients with COPD and low-risk PE (adjusted OR=1.53, 95%CI 1.03–2.29), and oral antiplatelet treatment was a protective factor (adjusted OR=0.71, 95%CI 0.31–0.84). Conclusions  Thrombocytosis is an independent risk factor for all-cause in-hospital mortality in COPD patients with PE at low risk. Antiplatelet therapy may play a protective role in the high-risk cohort.

Citation： GUO Lu, YANG Yang, JIANG Hongli, GONG Daoming, GAO Lingyun, YANG Yan, ZHANG Jing, ZHONG Tian, LIU Yuejian, JIE Zhengliang. Relationship between thrombocytosis and all-cause in-hospital mortality in patients with chronic obstructive pulmonary disease and low-risk pulmonary embolism. Chinese Journal of Respiratory and Critical Care Medicine, 2018, 17(1): 20-26. doi: 10.7507/1671-6205.201708041 Copy

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