The Relation of Obesity to Fatal Postoperative Pulmonary Embolism

Snell, Albert M.

doi:10.1001/archsurg.1927.01130200085006

Cited by 59 publications

(8 citation statements)

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“…Obesity was suspected as a risk factor for VTE as early as the 1920s in patients who suffered fatal postoperative PE, but consensus for obesity as an independent risk factor in both men and women has only recently developed [11,12,15,16]. In 2005, Stein and colleagues showed a relative risk (RR) in obese patients over twice that of nonobese patients for both PE (RR: 2.18; 95% CI: 2.16–2.19) and DVT (RR: 2.50; 95% CI: 2.49–2.51), and an incredible fivefold risk in patients under the age of 40 years (RR of PE: 5.19; CI: 5.11–5.28; RR of DVT: 5.2; 95% CI: 5.15–5.25) [11].…”

Section: Patients With Obesity Have An Enhanced Risk Of Vtementioning

confidence: 99%

Prevention of venous thromboembolism in obesity

Freeman

Pendleton

Rondina

2010

Expert Review of Cardiovascular Therapy

105

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Venous thromboembolism (VTE) is a significant cause of morbidity and mortality in hospitalized patients. Where appropriate, evidence-based methods of prophylaxis are implemented and the burden of VTE can be reduced substantially. Obesity, including morbid obesity, is associated with a high risk of VTE and, unfortunately, fixed doses of US FDA-approved anticoagulant regimens, including unfractionated heparins, low-molecular-weight heparins and factor Xa inhibitors, may not provide optimal VTE prophylaxis in these patients. Although the data are still limited, a rapidly growing body of literature and cumulative evidence suggests that anticoagulant dose adjustments in morbidly obese patients may optimize pharmacodynamic activity and reduce VTE risk. With the prevalence of morbid obesity continuing to rise, more high-quality clinical data are needed to better understand the pathobiology of VTE in obesity and provide effective, yet safe, prevention strategies.

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Section: Patients With Obesity Have An Enhanced Risk Of Vtementioning

confidence: 99%

Prevention of venous thromboembolism in obesity

Freeman

Pendleton

Rondina

2010

Expert Review of Cardiovascular Therapy

105

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“…Obesity.-Obese patients are very liable to pulmonary embolism, particularly following abdominal surgical operations (Snell, 1927). The combination of body-weight and the thick investment of adipose tissue in the flexures at the inguinal ligament encourage venous stasis and consequently thrombosis.…”

Section: Anticoagulant Therapy Anticoagulant Therapy In the Prophylaxmentioning

confidence: 99%

The prophylaxis of pulmonary embolism: A clinical programme

Gibbs

1959

Journal of British Surgery

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“…VTE is a multi‐factorial disease caused by interactions between acquired and inherited risk factors (Rosendaal, 1999). Among the acquired risk factors, numerous studies have shown a clear relationship between overweight (body mass index ≥ 25 kg/m 2 ) or obesity (body mass index ≥ 30 kg/m 2 ) and the risk of idiopathic VTE (Snell, 1927; Stein et al , 2005; Delluc et al , 2009). Obesity is also associated with a higher risk of recurrent VTE (Rodger et al , 2008).…”

mentioning

confidence: 99%

Site of venous thromboembolism and prothrombotic mutations according to body mass index. Results from the EDITH study

et al. 2011

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Summary This study evaluated the impact of body mass index (BMI) on venous thromboembolism (VTE) site and assessed a possible interaction between BMI and prothrombotic risk factors in patients included in the EDITH (Etude des Déterminants et Interactions de le THrombose veineuse) study. A cross‐sectional study was used to compare the site of unprovoked VTE according to BMI categories in 1077 patients and a matched case‐control study (732 pairs) assessed the joint effect of BMI and prothrombotic mutations on VTE risk. The cross sectional analysis showed that the proportion of patients with pulmonary embolism was higher in overweight (63%) and obese (63·5%) patients than among patients with a BMI < 25 kg/m2 (55%), P = 0·02 and P = 0·05 respectively. No interaction was found between F5 G1691A (factor V Leiden) and BMI for VTE risk (P = 0·90). There was a significant interaction between F2 G20210A and BMI (P = 0·02). The risk of VTE associated with BMI was 1·7 [95% confidence interval (CI): 0·8–3·7], 4·36 (95%CI: 1·49–12·78) and 12·03 (95%CI: 1·53–94·29) in patients with BMI < 25 kg/m2, 25 ≤ BMI < 30 and ≥30 kg/m2 respectively after adjustment for age and oestrogen use. This study showed that BMI may play a role in determining the site of VTE and may interact with F2 G20210A but not with F5 G1691A for the risk of VTE.

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The Relation of Obesity to Fatal Postoperative Pulmonary Embolism

Cited by 59 publications

References 0 publications

Prevention of venous thromboembolism in obesity

Prevention of venous thromboembolism in obesity

The prophylaxis of pulmonary embolism: A clinical programme

Site of venous thromboembolism and prothrombotic mutations according to body mass index. Results from the EDITH study

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