• Francesco Dentali, Fulvio Pomero, Micco Pierpaolo Di PD Department of Internal Medicine and Emergency Room, Ospedale Buon Consiglio Fatebenefratelli, Naples, Italy., Micaela La Regina, Federica Landini, Nicola Mumoli, Filippo Pieralli, Matteo Giorgi-Pierfranceschi, Roberta Re, Josè Vitale, Leonardo M Fabbri, Andrea Fontanella, Dimitriy Arioli, and Young-FADOI Study Group.
• Department of Medicine and Surgery, Insubria University, Varese, Italy. Electronic address: fdentali@libero.it.
• Eur. J. Intern. Med. 2020 Oct 1; 80: 54-59.

IntroductionPulmonary embolism (PE) prevalence in acute exacerbations of COPD is highly variable.MethodsTo investigate the prevalence and risk factors of PE in patients hospitalized in Departments of Internal Medicine because of AECOPD and suspected PE we conducted a retrospective multicenter study in patients with an AECOPD undergoing chest angio-computed tomography (angio-CT) because of clinical suspect of PE.Results1043 patients (mean age 75.8 years ± 9.7 years, 34.5 % women) were included; 132 patients had PE (mean prevalence 12.66%, 95% confidence interval 10.73, 14.77%).) confirmed by angio-CT and 54 patients died during hospitalization (5.18 %). At multivariate analysis, age, female gender, clinical signs and symptoms suggestive of deep vein thrombosis, hypertension, PaCO2 ≤ 40 mmHg, and normal chest-x-ray were significantly associated with a higher PE prevalence. Prevalence of PE in patients with 0, 1, 2, 3 or ≥4 risk factors progressively increase from 1.76 to 30.43%. Mean length of hospitalization (LOH) (15.7 vs 14.2 days, p 0.07) and in-hospital mortality (6.1% vs 5.1%, P=0.62) were slightly but not significantly higher in in patients with PE (6.1% vs 5.1%, P=0.62).ConclusionsPE prevalence is not negligible in this setting. A number of risk factors may help clinicians in identification of patients at increased risk of PE.Copyright © 2020 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

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