Sex differences in risk of venous thromboembolism in patients with acute exacerbation of chronic obstructive pulmonary disease

Little is known about the association between sex and venous thromboembolism (VTE) event in acute exacerbation of chronic obstructive pulmonary disease (AECOPD) patients. This study aimed to explore sex differences in risk of VTE event in patients with AECOPD and compare risk factors for VTE in different sex groups. The patients hospitalized for AECOPD were prospectively enrolled from ten medical centers in China. The baseline characteristics, comorbidities, in-hospital complications, laboratory and radiographic tests, treatments, VTE events and other clinical adverse outcomes between female and male patients with AECOPD were compared.A total of 13664 AECOPD patients were included in our study, of which 2934 (21.5%) were females and 10730 (78.5%) were males. The incidence of VTE in female patients was 5.5%, which was significantly higher than that in male patients (3.3%, P＜0.001). After adjusting for other known risk factors for VTE, females were still associated with an increased risk of VTE event in AECOPD population (OR = 1.439, 95% CI = 1.177-1.759, P <0.001). Age, chronic heart failure, severe lung disease, stroke, recent surgery, history of VTE and respiratory failure were common independent risk factors for both female and male patients, while sepsis, varicose veins and rheumatological disorder were VTE risk factors unique to male patients. Among the AECOPD inpatients, female is associated with an increased risk of VTE. There are common risk factors of VTE for female and male patients and also risk factors unique to male patients. These findings may facilitate clinical decision making regarding VTE prophylaxis in patients with AECOPD.