The prevalence and risk factors of pulmonary embolism in patients with chronic obstructive pulmonary disease: a systematic review and meta-analysis
Bibliographic record
Abstract
An increased prevalence of PE has been found in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD). Early identification of risk factors for the development of PE in patients with AECOPD and intervention is important. Therefore, we comprehensively pool and analyze the prevalence and risk factors of PE among patients experiencing AECOPD, aiming to provide valuable insights for clinical-based diagnostic determination and prevention of PE in the AECOPD patient population. A systematic literature search was conducted for studies reporting the incidence and risk factors for PE in patients with AECOPD. Study quality was assessed using the modified Newcastle-Ottawa Quality Assessment Scale. The degree of heterogeneity was assessed by the I 2 statistic. The publication bias (studies ≥ 10) was evaluated using Egger’s test. Among the 1421 studies initially retrieved, 22 articles were ultimately selected and incorporated into the analysis. Based on the meta-analysis and the review’s updated findings, the prevalence of PE in AECOPD is 17.82% (95% CI 12.72%-23.57%, P <0.001). The following factors were identified as risk factors for PE among patients with AECOPD: age(weighted mean difference [WMD] 2.0119, 95% CI 0.7126–3.3133, I 2 = 51.8%, P = 0.02), males(odds ratio [ OR ] 0.9528, 95% CI 0.6869–1.3216, I 2 = 65.0%, P <0.001), obesity( OR 1.3086, 95% CI 0.1895–9.0385, I 2 = 74.5%, P = 0.02), malignant disease( OR 1.5902, 95% CI 0.9689–2.6097, I 2 = 54.7%, P = 0.03), hypertension( OR 1.0663, 95% CI 0.7920–1.4355, I 2 = 57.7%, P = 0.009), immobilization ≥ 3d( OR 3.9158, 95% CI 1.0925–14.0354, I 2 = 91.6%, P <0.001), edema of lower limb( OR 2.1558, 95% CI 1.3365–3.4773, I 2 = 75.4%, P <0.001), pulmonary hypertension( OR 1.3146, 95% CI 0.7481-2.3100, I 2 = 70.1%, P = 0.04), cough( OR 0.7084, 95% CI 0.1304–3.8497, I 2 = 88.8%, P <0.001), purulent sputum( OR 0.7570, 95% CI 0.4005–1.4309, I 2 = 61.9%, P = 0.049), and D-dimer(WMD 0.8619, 95% CI 0.0449–1.6789, I 2 = 91.4%, P <0.001), C-reactive protein(CRP)(WMD 0.8852, 95% CI -4.0639-5.8344, I 2 = 76.4%, P = 0.005) or fibrinogen(WMD 0.8663, 95% CI -0.2572-1.9898, I 2 = 92.2%, P <0.001) levels. Clinical risk factors(including S1Q3 pattern on electrocardiograph(ECG), hospital stay and home oxygen therapy) showed no significant association with the occurrence of PE ( P >0.05). This updated meta-analysis and systematic review revealed that the prevalence of pulmonary embolism in the AECOPD was 17.82%. This figure may vary depending on how the diagnostic procedure is carried out. Age, males, obesity, malignant disease, hypertension, immobilization ≥ 3d, edema of lower limb, pulmonary hypertension, cough, purulent sputum, and D-dimer, CRP or fibrinogen level may serve as potential risk factors for PE among patients with AECOPD.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.013 | 0.032 |
| Meta-epidemiology (narrow) | 0.003 | 0.002 |
| Meta-epidemiology (broad) | 0.019 | 0.039 |
| Bibliometrics | 0.008 | 0.009 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".