Key result
Higher Wells score linked to ~73% greater risk of pulmonary embolism in AECOPD.
Why the study?
The predictive value of thrombin generation indices and Wells score for pulmonary embolism in patients with acute exacerbation of COPD was unclear.
Do thrombin generation indices and Wells score predict pulmonary embolism in patients with acute exacerbation of chronic obstructive pulmonary disease?
Case-Control (n=160)
No
Do thrombin generation indices and Wells score predict pulmonary embolism in patients with acute exacerbation of chronic obstructive pulmonary disease?
Odds Ratio: 1.732 (95% CI 1.21–2.479)
p-value: p=<0.05
Thrombin generation indices and the Wells score are independent risk factors and effective predictors for pulmonary embolism in patients with acute exacerbation of COPD.
Supports Wells score for PE risk stratification in AECOPD; hypothesis-generating and requires prospective validation before clinical adoption.
• History of venous thromboembolism, d -Dimer as well as ETP, APTT coagulation indices, and Wells score were significantly higher in the AECOPD with PE group, and ttpeak, ALB and TP were lower. • Wells score had a positive correlation with ETP and APTT and a negative correlation with ttpeak, which were all independent risk factors for PE in AECOPD. • Wells score, ETP, APTT and ttpeak had the efficacy of predicting PE by ROC curve analysis. This study investigated the predictive value of thrombin generation indices and Wells score in the development of Pulmonary Embolism (PE) in patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease (AECOPD). 160 patients who were admitted for AECOPD and underwent CT Pulmonary Arteriography (CTPA) were collected. Among them, a total of 62 cases were diagnosed with PE as the AECOPD with PE group, and the other 98 cases were not diagnosed with PE as the AECOPD group. The general data, past history and combined basic diseases, laboratory tests and other related clinical data of the two groups were compared, and the data collected were statistically analyzed to explore the diagnostic indexes that can predict PE in AECOPD. History of venous thromboembolism, d -Dimer as well as Endogenous Thrombin Potential (ETP), Activated Partial Thromboplastin Time (APTT) coagulation indices, and Wells score was significantly higher in the AECOPD with PE group than in the AECOPD group, and Time to Peak (ttpeak), Albumin (ALB) and total protein were lower than those in the AECOPD group. The Wells score had a positive correlation with ETP and APTT and a negative correlation with ttpeak, which were all independent risk factors for PE in AECOPD. The Wells score had the best efficacy in predicting the occurrence of PE in patients with AECOPD with a cutoff value of 4.62. Significant correlations were found between the thrombin generation indices (ETP, APTT and ttpeak) and the Wells score, which can also be used for early diagnosis of PE in patients with AECOPD.
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Luo et al. (2025) conducted a case-control in Acute Exacerbation of Chronic Obstructive Pulmonary Disease (AECOPD) (n=160). Wells score and thrombin generation indices vs. Lower scores/indices was evaluated on Occurrence of Pulmonary Embolism (OR 1.732, 95% CI 1.210-2.479, p=<0.05). The Wells score was an independent risk factor for pulmonary embolism in patients with acute exacerbation of chronic obstructive pulmonary disease (OR 1.732) and demonstrated predictive efficacy with an AUC of 0.728.
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