Higher body mass index raises immature platelet count: potential contribution to obesity-related thrombosis

Goudswaard, Lucy J; Corbin, Laura J; Burley, K; Mumford, Andrew D; Akbari, Parsa; Soranzo, Nicole; Butterworth, Adam S.; Watkins, Nicholas A.; Pournaras, Dimitri J.; Harris, Jessica; Timpson, Nicholas J.; Hers, Ingeborg

doi:10.1080/09537104.2021.2003317

Cited by 10 publications

(14 citation statements)

References 38 publications

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“…There is outpatient adult data suggesting that while women are more frequently referred for DVT workup, the rate of DVT detection is higher in men and they may have more extensive thromboses 17,18 . Obesity is a known risk factor for thrombosis, but in our cohort, the body mass index was not different between males versus females 19 . This gender difference may be reflective of the epidemiologic differences in children with trauma as globally, male children suffer more TBI than female children 16 …”

Section: Discussionmentioning

confidence: 59%

“…17,18 Obesity is a known risk factor for thrombosis, but in our cohort, the body mass index was not different between males versus females. 19 This gender difference may be reflective of the epidemiologic differences in children with trauma as globally, male children suffer more TBI than female children. 16 The most recent CHEST guidelines note that 95% of VTE in children are secondary to an identifiable risk factor, which is most frequently a central venous access device.…”

Section: Discussionmentioning

confidence: 99%

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Catheter‐associated deep vein thrombosis in children with severe traumatic brain injury: A single‐center experience

Lovett

Daniel

Keesari

et al. 2022

Pediatric Blood & Cancer

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Background: This study was performed to describe the single-center experience of deep vein thrombosis (DVT) in children with severe traumatic brain injury (sTBI) who were mechanically ventilated with a central line, and to identify potentially modifiable risk factors. It was hypothesized that children with DVT would have a longer duration of central venous line (CVL) and a higher use of hypertonic saline (HTS) compared to those without DVT.Procedure/methods: This was a retrospective study of children (0-18 years) with sTBI, who were intubated, had a CVL, and a minimum intensive care unit (ICU) stay of 3 days.Children were analyzed by the presence or absence of DVT. HTS use was evaluated using milliliter per kilogram (ml/kg) of 3% equivalents. Univariable and multivariable logistic regression models were used to determine which factors were associated with DVT.Results: Seventy-seven children met inclusion criteria, 23 (29.9%) had a DVT detected in an extremity. On univariable analysis, children with DVT identified in an extremity had prolonged CVL use (14 vs. 8.5 days, p = .021) and longer duration of mechanical ventilation (15 vs. 10 days, p = .013). HTS 3% equivalent ml/kg was not different between groups. On multivariable analysis, mechanical ventilation duration was associated with DVT detection in an extremity, whereas neither CVL duration nor HTS use had an association.Conclusions: There was a high incidence of extremity DVT detected in children with sTBI who received invasive mechanical ventilation and had a CVL. HTS administration was not associated with DVT detection in an extremity.

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Section: Discussionmentioning

confidence: 59%

Section: Discussionmentioning

confidence: 99%

Catheter‐associated deep vein thrombosis in children with severe traumatic brain injury: A single‐center experience

Lovett

Daniel

Keesari

et al. 2022

Pediatric Blood & Cancer

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“…We also found an association between obesity and longer catheter dwell time. Interestingly, this factor has been described in the literature as a risk factor for catheter colonization and CRI [ 31 , 32 ], as well as for DVT [ 33 , 34 ]. Strategies to prevent catheter-related intravascular complications could thus be particularly beneficial in these patients.…”

Section: Discussionmentioning

confidence: 99%

Development and validation of a multivariable model predicting the required catheter dwell time among mechanically ventilated critically ill patients in three randomized trials

Iachkine

Buetti

Grooth

et al. 2023

Ann. Intensive Care

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Background The anatomic site for central venous catheter insertion influences the risk of central venous catheter-related intravascular complications. We developed and validated a predictive score of required catheter dwell time to identify critically ill patients at higher risk of intravascular complications. Methods We retrospectively conducted a cohort study from three multicenter randomized controlled trials enrolling consecutive patients requiring central venous catheterization. The primary outcome was the required catheter dwell time, defined as the period between the first catheter insertion and removal of the last catheter for absence of utility. Predictors were identified in the training cohort (3SITES trial; 2336 patients) through multivariable analyses based on the subdistribution hazard function accounting for death as a competing event. Internal validation was performed in the training cohort by 500 bootstraps to derive the CVC-IN score from robust risk factors. External validation of the CVC-IN score were performed in the testing cohort (CLEAN, and DRESSING2; 2371 patients). Results The analysis was restricted to patients requiring mechanical ventilation to comply with model assumptions. Immunosuppression (2 points), high creatinine > 100 micromol/L (2 points), use of vasopressor (1 point), obesity (1 point) and older age (40–59, 1 point; ≥ 60, 2 points) were independently associated with the required catheter dwell time. At day 28, area under the ROC curve for the CVC-IN score was 0.69, 95% confidence interval (CI) [0.66–0.72] in the training cohort and 0.64, 95% CI [0.61–0.66] in the testing cohort. Patients with a CVC-IN score ≥ 4 in the overall cohort had a median required catheter dwell time of 24 days (versus 11 days for CVC-IN score < 4 points). The positive predictive value of a CVC-IN score ≥ 4 was 76.9% for > 7 days required catheter dwell time in the testing cohort. Conclusion The CVC-IN score, which can be used for the first catheter, had a modest ability to discriminate required catheter dwell time. Nevertheless, preference of the subclavian site may contribute to limit the risk of intravascular complications, in particular among ventilated patients with high CVC-IN score. Trials Registration NCT01479153, NCT01629550, NCT01189682

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“…A post hoc analysis of the Aspirin in Reducing Events in the Elderly Trial (ASPREE) in patients ≥70 years of age without documented cardiovascular and cerebrovascular disease or high risk of bleeding found no association between low‐dose ASA cardiovascular disease events with body weight or other measures of body habitus 32 . Other studies, have also shown that obesity is associated with impaired responsiveness to ASA 10,24,33–35 …”

Section: Discussionmentioning

confidence: 99%

Prospective, randomized, controlled, trial to assessASADOSingby body mass index inHEalthyvolunteers (DOSEstudy)

et al. 2023

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Study Objective: Aspirin (ASA) has demonstrated inconsistent results in primary prevention of cardiovascular disease (CVD). Guidelines are also inconsistent in the recommendation of routine ASA use for primary prevention of CVD, but advocate dosing as a "one-size-fits-all" approach.Design: An intention-to-treat, double-blind, randomized, controlled, clinical trial comparing three treatment arms of ASA 81, 325, and 500 mg daily dosed for 14 days were evenly randomized across the dosing categories to measure the impact of dosing by body mass index (BMI) (20-24.9, 25-29.9, ≥30 kg/m 2 ) on ASA anti-platelet effects.Setting: University Ambulatory Clinic.Patients: Healthy volunteers defined as individuals who were medication free without acute or chronic significant health problems.Intervention: Change in ASA reactivity unit (ARU), salicylate levels, and thromboxane B2 (TxB2) levels were measured across BMI dosing categories and time.Main Results: Fifty-four participants with a mean (±SD) age of 34.4 ± 10.9 years (M:F; 23:31) completed the study. Baseline ARU and TxB2 levels were not significantly different between obese and non-obese individuals. BMI was not a predictor of platelet inhibition. There was no interaction between gender and platelet activation at baseline or following ASA treatment. ASA 81 mg was associated with a lower ARU response (approximate 50% lower response) than either the 325-mg or the 500-mg doses of ASA. TxB2 and salicylate levels exhibited lower trends at 81 mg compared with higher doses. Conclusions:In healthy male and female participants administered ASA for 14 days, obesity is not associated with increased basal platelet activation or ASA resistance.ASA 81 mg was significantly less effective in reducing platelet aggregation compared with ASA 325 and 500 mg, independent of BMI.

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Higher body mass index raises immature platelet count: potential contribution to obesity-related thrombosis

Cited by 10 publications

References 38 publications

Catheter‐associated deep vein thrombosis in children with severe traumatic brain injury: A single‐center experience

Catheter‐associated deep vein thrombosis in children with severe traumatic brain injury: A single‐center experience

Development and validation of a multivariable model predicting the required catheter dwell time among mechanically ventilated critically ill patients in three randomized trials

Prospective, randomized, controlled, trial to assessASADOSingby body mass index inHEalthyvolunteers (DOSEstudy)

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