Khalid Muhammad Umar, Prasada Sameer, Jennings Courtney, Bartholomew John R, McCarthy Meghann, Hornacek Deborah A, Joseph Douglas, Chen Wei, Schwarz Graham, Bhandari Rohan, Elbadawi Ayman, Cameron Scott J
Section of Vascular Medicine, Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic Foundation, Cleveland, OH, USA.
Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic Foundation, Cleveland, OH, USA.
Vasc Med. 2024 Feb;29(1):42-47. doi: 10.1177/1358863X231219006.
Patients with lymphedema and lipedema share physical exam findings that may lead to misdiagnosis. Poor mobility is common in patients with obesity and patients with lymphedema and lipedema. This may constitute a risk factor for venous thromboembolism (VTE). Our objective was to evaluate the association of VTE in obese patients with lymphedema and lipedema.
The National Inpatient Sample (NIS) was searched from 2016 to 2020 to identify hospital admissions of obese female patients with lymphedema and lipedema. Patients were analyzed in the context of presence or absence of VTE while adjusting for complex cluster sampling techniques. Predictors of VTE were accessed by multivariable regression.
Lymphedema was identified in 189,985 patients and lipedema in 50,645 patients. VTE was observed in 3.12% ( = 374,210) of patients with obesity. In patients with obesity, VTE was more common in patients with lymphedema than without (2.6% vs 1.6%; < 0.01). Similarly, VTE was more common in patients with lipedema than without (0.6% vs 0.4%; < 0.01). After multivariable logistic regression, VTE events in obese patients with lymphedema were higher versus without (OR 1.6; CI 1.08-2.43; = 0.02). Similarly, VTE events were more common in obese patients with lipedema versus obese patients without lipedema (OR 1.20; CI 1.03-1.41; = 0.02).
In this hypothesis-generating study, lymphedema and lipedema show a positive association with VTE after adjusting for baseline patient characteristics such as obesity, which is a known independent risk factor for VTE. Mechanisms whereby lymphedema and lipedema are associated with VTE should be investigated.
淋巴水肿和脂肪性水肿患者的体格检查结果可能导致误诊。肥胖患者以及淋巴水肿和脂肪性水肿患者普遍存在行动不便的情况。这可能构成静脉血栓栓塞（VTE）的一个危险因素。我们的目的是评估肥胖合并淋巴水肿和脂肪性水肿患者中VTE的相关性。
检索2016年至2020年的全国住院患者样本（NIS），以确定肥胖女性淋巴水肿和脂肪性水肿患者的住院情况。在调整复杂整群抽样技术的情况下，对患者进行有无VTE的分析。通过多变量回归分析VTE的预测因素。
共识别出189,985例淋巴水肿患者和50,645例脂肪性水肿患者。肥胖患者中观察到VTE的比例为3.12%（n = 374,210）。在肥胖患者中，淋巴水肿患者发生VTE的情况比无淋巴水肿患者更常见（2.6%对1.6%；P < 0.01）。同样，脂肪性水肿患者发生VTE的情况比无脂肪性水肿患者更常见（0.6%对0.4%；P < 0.01）。经过多变量逻辑回归分析，肥胖合并淋巴水肿患者的VTE事件发生率高于无淋巴水肿患者（比值比1.6；可信区间1.08 - 2.43；P = 0.02）。同样，肥胖合并脂肪性水肿患者的VTE事件比无脂肪性水肿的肥胖患者更常见（比值比1.20；可信区间1.03 - 1.41；P = 0.02）。
在这项生成假设的研究中，在调整了肥胖等基线患者特征（肥胖是已知的VTE独立危险因素）后，淋巴水肿和脂肪性水肿与VTE呈正相关。应研究淋巴水肿和脂肪性水肿与VTE相关的机制。
