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. 2025 Feb 27:80:100582.
doi: 10.1016/j.clinsp.2025.100582. eCollection 2025.

Thrombin generation indices and Wells score predict pulmonary embolism in patients with acute exacerbation of chronic obstructive pulmonary disease

Linjie Luo  1 , Dan Zheng  2 , Li Da  2 , Jian Cheng  2 , Yirui Cao  2 , Na Wang  2
Affiliations

Thrombin generation indices and Wells score predict pulmonary embolism in patients with acute exacerbation of chronic obstructive pulmonary disease

Linjie Luo et al. Clinics (Sao Paulo). .

Abstract

Objective: 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).

Methods: 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.

Results: 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.

Conclusion: 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.

Keywords: AECOPD; PE; Thrombin Generation; Wells Score.

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Conflict of interest statement

Conflicts of interest The authors declare no conflicts of interest.

Figures

Fig 1
Fig. 1
Accuracy of Wells score for PE. AECOPD, Acute Exacerbation of Chronic Obstructive Pulmonary Disease; PE, Pulmonary Embolism; LR, Low Risk; MR, Moderate Risk; HR, High Risk.
Fig 2
Fig. 2
A forest plot based on multifactorial logistic regression analysis to analyze the independent factors influencing the occurrence of PE (*p<0.05). APTT, Activated Partial Thromboplastin Time; ttpeak, Time to peak; ETP, Endogenous Thrombin Potential; TP, Total Protein; ALB, Serum Albumin; DVT, Deep Vein Thrombosis; OR, Odds Radio; CI, Confidence Interval.
Fig 3
Fig. 3
Correlation analysis between Wells score and ETP, APTT, and ttpeak levels. (A) Comparison of ETP, APTT and ttpeak between LR, MR, and HR groups; (B) Pearson analysis of the correlation between Wells score and ETP, APTT, and ttpeak. *p < 0.05, indicates significant difference between two groups; #p < 0.05, indicates significant difference between three groups. LR, Low Risk; MR, Moderate Risk; HR, High Risk; ETP, Endogenous Thrombin Potential; ttpeak, Time to peak; APTT, Activated Partial Thromboplastin Time.
Fig 4
Fig. 4
ROC curve analysis of the predictive value of ETP, TPH, APTT, and ttpeak and Wells score for PE in patients (*p<0.05). ETP, Endogenous Thrombin Potential; ttpeak, Time to peak; APTT, Activated Partial Thromboplastin Time; ROC, Receiver Operating Characteristic; AUC, Area Under the Curve; CI, Confidence Interval.
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