Obesity as a risk factor in venous thromboembolism

Stein, Paul D.; Beemath, Afzal; Olson, R. E.

doi:10.1016/j.amjmed.2005.03.012

Cited by 515 publications

(339 citation statements)

References 12 publications

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“…26 The National Hospital Discharge Survey showed that obesity conferred a relative risk of 2.18 and 2.50 for PE and deep venous thrombosis, respectively. 27 Our study supports the association of BMI and VTE risk in COPD individuals with moderate to severe airflow obstruction.…”

Section: Discussionsupporting

confidence: 88%

Risk Factors for Venous Thromboembolism in Chronic Obstructive Pulmonary Disease

Kim¹,

Goel²,

Gangar³

et al. 2014

J COPD F

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Background COPD patients are at increased risk for venous thromboembolism (VTE). VTE however remains under-diagnosed in this population and the clinical profile of VTE in COPD is unclear. Methods Global initiative for chronic Obstructive Lung Disease (GOLD) stages II-IV participants in the COPD Genetic Epidemiology (COPDGene) study were divided into 2 groups: VTE+, those who reported a history of VTE by questionnaire, and VTE−, those who did not. We compared variables in these 2 groups with either t-test or chi-squared test for continuous and categorical variables, respectively. We performed a univariate logistic regression for VTE, and then a multivariate logistic regression using the significant predictors of interest in the univariate analysis to ascertain the determinants of VTE. Results The VTE+ group was older, more likely to be Caucasian, had a higher body mass index (BMI), smoking history, used oxygen, had a lower 6-minute walk distance, worse quality of life scores, and more dyspnea and respiratory exacerbations than the VTE− group. Lung function was not different between groups. A greater percentage of the VTE+ group described multiple medical comorbidities. On multivariate analysis, BMI, 6-minute walk distance, pneumothorax, peripheral vascular disease, and congestive heart failure significantly increased the odds for VTE by history. Conclusions BMI, exercise capacity, and medical comorbidities were significantly associated with VTE in moderate to severe COPD. Clinicians should suspect VTE in patients who present with dyspnea and should consider possibilities other than infection as causes of COPD exacerbation.

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Section: Discussionsupporting

confidence: 88%

Risk Factors for Venous Thromboembolism in Chronic Obstructive Pulmonary Disease

Kim¹,

Goel²,

Gangar³

et al. 2014

J COPD F

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“…Venous thromboembolisms are a challenging problem for orthopaedic surgeons. Stein et al [37] investigated the potential risk of obesity in patients with venous thromboembolism based on the database of the National Hospital Discharge Survey and indicated that obesity was a risk factor for men and women. Results of our meta-analysis were consistent with their study and showed that obesity was associated with a higher risk of venous thromboembolism.…”

Section: Discussionmentioning

confidence: 99%

Does Obesity Affect the Surgical Outcome and Complication Rates of Spinal Surgery? A Meta-analysis

Jiang

Teng

Fan

et al. 2014

Clinical Orthopaedics &Amp; Related Research

170

130

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Background As obesity becomes more prevalent, it becomes more common among patients considering orthopaedic surgery, including spinal surgery. However, there is some controversy regarding whether obesity is associated with complications, failed reconstructions, or reoperations after spinal surgery. Questions/purposes We wished to determine, in patients undergoing spine surgery, whether obesity is associated with (1) surgical site infection, (2) mortality and the need for revision surgery after spinal surgery, and (3) increased surgical time and blood loss. Methods A systematic literature search was performed to collect comparative or controlled studies that evaluated the influence of obesity on the surgical and postoperative outcomes of spinal surgery. Two reviewers independently selected trials, extracted data, and assessed the methodologic quality and quality of evidence. Pooled odds ratios (OR) and mean differences (MD) with 95% CIs were calculated using the fixed-effects model or random-effects model. Data were analyzed using RevMan 5.1. MOOSE criteria were used to ensure this project's validity. Thirtytwo studies involving 97,326 patients eventually were included. Results Surgical site infection (OR, 2.33; 95% CI, 1.94-2.79), venous thromboembolism (OR, 3.15; 95% CI, 1.92-5.17), mortality (OR, 2.6; 95% CI, 1.50-4.49), revision rate (OR, 1.43; 95% CI, 1.05-1.93) operating time (OR, 14.55; 95% CI,, and blood loss (MD, 28.89; 95% CI,, were all significantly increased in the obese group. Conclusion Obesity seemed to be associated with higher risk of surgical site infection and venous thromboembolism, more blood loss, and longer surgical time. Future prospective studies are needed to confirm the relationship between obesity and the outcome of spinal surgery.

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“…Furthermore, the relative size of the gap as a percentage of the recommended dose also increased with body weight, thereby magnifying the risk of harm among more severely obese patients, who already face an increased risk of recurrence. 2,12 While a 100-kg patient received, on average, 77% (1380/1800) of the recommended initial continuous infusion, a 175-kg patient received 62% (1965/3150) of the recommended dose.…”

Section: Discussionmentioning

confidence: 99%