Sophie Samuel1, Leigh Gomez2, Jude P Savarraj3, Suhas Bajgur3, Huimahn A Choi3. 1. Department of Pharmacy, Memorial Hermann-Texas Medical Center, Houston, Texas. 2. Department of Pharmacy, Nebraska Medicine, Omaha, Nebraska. 3. Department of Neurosurgery and Neurology, The University of Texas Medical School at Houston, Houston, Texas.
Abstract
STUDY OBJECTIVE: To assess whether a positive linear association exists between body mass index (BMI) and incidence of venous thromboembolism (VTE) in overweight and obese hospitalized patients. DESIGN: Single-center retrospective observational cohort study. SETTING: Large academic tertiary care medical center. PATIENTS: A total of 1452 adults hospitalized between January 1, 2013, and December 31, 2014, who weighed more than 100 kg and had a BMI of 25 kg/m2 or greater on admission, and received heparin subcutaneously for VTE prophylaxis. Patients were categorized into four subgroups based on World Health Organization BMI classification: overweight (141 patients), obese class I (305 patients), obese class II (324 patients), and obese class III (682 patients). MEASUREMENTS AND MAIN RESULTS: The primary outcome was occurrence of VTE in each subgroup; all-cause mortality and length of hospital stay were secondary outcomes. A linear trend test did not show an association between occurrence of VTE and BMI of 25 kg/m2 or greater. VTE occurred in 7 (5%) of 141 patients in the overweight group, 5 (2%) of 305 in the obese class I group, 8 (3%) of 324 in the class II group, and 18 (3%) of 682 in the class III group (p=0.573). In addition, no linear association was noted between all-cause mortality or length of hospital stay and BMI of 25 kg/m2 or greater. Overall mortality was 10% (146/1452 patients). Ten deaths (7%) occurred in the overweight group, 45 (15%) in the obese class I group, 38 (12%) in the obese class II group, and 53 (8%) in the obese class III group (p=0.067). The median length of hospital stay was 5 days (interquartile range 3-9, p=0.122) for all patients. CONCLUSION: In overweight and obese hospitalized patients who weighed more than 100 kg and had a BMI of 25 kg/m2 or greater, the incidence of VTE did not increase incrementally with increasing severity of obesity.
STUDY OBJECTIVE: To assess whether a positive linear association exists between body mass index (BMI) and incidence of venous thromboembolism (VTE) in overweight and obese hospitalized patients. DESIGN: Single-center retrospective observational cohort study. SETTING: Large academic tertiary care medical center. PATIENTS: A total of 1452 adults hospitalized between January 1, 2013, and December 31, 2014, who weighed more than 100 kg and had a BMI of 25 kg/m2 or greater on admission, and received heparin subcutaneously for VTE prophylaxis. Patients were categorized into four subgroups based on World Health Organization BMI classification: overweight (141 patients), obese class I (305 patients), obese class II (324 patients), and obese class III (682 patients). MEASUREMENTS AND MAIN RESULTS: The primary outcome was occurrence of VTE in each subgroup; all-cause mortality and length of hospital stay were secondary outcomes. A linear trend test did not show an association between occurrence of VTE and BMI of 25 kg/m2 or greater. VTE occurred in 7 (5%) of 141 patients in the overweight group, 5 (2%) of 305 in the obese class I group, 8 (3%) of 324 in the class II group, and 18 (3%) of 682 in the class III group (p=0.573). In addition, no linear association was noted between all-cause mortality or length of hospital stay and BMI of 25 kg/m2 or greater. Overall mortality was 10% (146/1452 patients). Ten deaths (7%) occurred in the overweight group, 45 (15%) in the obese class I group, 38 (12%) in the obese class II group, and 53 (8%) in the obese class III group (p=0.067). The median length of hospital stay was 5 days (interquartile range 3-9, p=0.122) for all patients. CONCLUSION: In overweight and obese hospitalized patients who weighed more than 100 kg and had a BMI of 25 kg/m2 or greater, the incidence of VTE did not increase incrementally with increasing severity of obesity.