Clinical relevance of chronic respiratory disease in Korean patients with pulmonary thromboembolism

Background: Data regarding clinical and radiological features of patients with pulmonary thromboembolism (PTE) and concomitant chronic respiratory disease (CRD) are limited. Accordingly, the aim of the present study was to investigate clinico-radiological features of this patient population. Methods: Patients with PTE were retrospectively classified into one of two groups: those with and without CRD. Clinical characteristics, blood biomarkers, and computed tomographic (CT) findings were compared between the groups. Results: Of 1,207 PTE patients included, CRD was detected in 128 (11%). The most common CRD was chronic obstructive pulmonary disease [41 (32%)], followed by bronchial anthracofibrosis [32 (25%)]. In multivariate analysis, unprovoked PTE [odds ratio (OR) 1.99, 95% confidence interval (CI): 1.29–3.05, P=0.002], dyspnea (OR 1.54, 95% CI: 1.11–2.34, P=0.041), lower respiratory tract infection (LRTI) (OR 3.90, 95% CI: 2.13–7.14, P<0.001), Pulmonary Embolism Severity Index (PESI) class IV–V (OR 5.24, 95% CI: 3.43–8.00, P<0.001), in-situ pulmonary artery thrombosis (OR 10.62, 95% CI: 3.71–30.45, P<0.001), and pulmonary artery enlargement (OR 1.65, 95% CI: 3.71–30.45, P<0.001) were found to be independent clinical factors related to CRD in patients with PTE. CRD was an independent predictor of PTE-related in-hospital mortality (OR 3.96, 95% CI: 1.32–11.88, P=0.014). Conclusions: Patients with PTE and concomitant CRD were characterized by higher incidences of dyspnea, LRTI, PESI class IV–V, and in-situ pulmonary artery thrombosis, compared with non-CRD patients. In these patients, CRD was a predictor of PTE-related in-hospital mortality.