Department of Pharmacy, Memorial Hermann-Texas Medical Center, Houston, Texas.
Department of Pharmacy, Nebraska Medicine, Omaha, Nebraska.
Pharmacotherapy. 2017 Aug;37(8):893-899. doi: 10.1002/phar.1953. Epub 2017 Jun 21.
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.
Single-center retrospective observational cohort study.
Large academic tertiary care medical center.
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/m 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).
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/m 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/m 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.
In overweight and obese hospitalized patients who weighed more than 100 kg and had a BMI of 25 kg/m or greater, the incidence of VTE did not increase incrementally with increasing severity of obesity.
评估超重和肥胖住院患者的体重指数（BMI）与静脉血栓栓塞症（VTE）发生率之间是否存在正线性关联。
单中心回顾性观察队列研究。
大型学术三级保健医疗中心。
2013 年 1 月 1 日至 2014 年 12 月 31 日期间，共 1452 名体重超过 100 公斤且入院时 BMI 为 25kg/m2 或更高的住院成人，接受皮下肝素预防 VTE。根据世界卫生组织 BMI 分类，患者分为四组：超重（141 例）、肥胖 I 级（305 例）、肥胖 II 级（324 例）和肥胖 III 级（682 例）。
主要结局是每组 VTE 的发生情况；全因死亡率和住院时间为次要结局。线性趋势检验未显示 VTE 发生与 BMI 为 25kg/m2 或更高之间存在关联。超重组 141 例患者中发生 VTE 7 例（5%），肥胖 I 级组 305 例患者中发生 VTE 5 例（2%），肥胖 II 级组 324 例患者中发生 VTE 8 例（3%），肥胖 III 级组 682 例患者中发生 VTE 18 例（3%）（p=0.573）。此外，BMI 为 25kg/m2 或更高与全因死亡率或住院时间之间未观察到线性关联。总体死亡率为 10%（146/1452 例患者）。超重组死亡 10 例（7%），肥胖 I 级组死亡 45 例（15%），肥胖 II 级组死亡 38 例（12%），肥胖 III 级组死亡 53 例（8%）（p=0.067）。所有患者的中位住院时间为 5 天（四分位距 3-9，p=0.122）。
在体重超过 100 公斤且 BMI 为 25kg/m2 或更高的超重和肥胖住院患者中，VTE 的发生率并未随肥胖严重程度的增加而递增。
