Risk of Venous Thromboembolism and Efficacy of Thromboprophylaxis in Hospitalized Obese Medical Patients and in Obese Patients Undergoing Bariatric Surgery

Rocha, Ana Thereza; Vasconcellos, Ângela G.; Neto, Epitácio R da Luz; Araujo, Danilo Martínez; Alves, Erivaldo; Lopes, Antônio Alberto

doi:10.1381/096089206779319383

Cited by 139 publications

(82 citation statements)

References 41 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…8 Two smaller studies of elective hip replacement found relative risks of Ϸ2.0 in overweight and obese patients relative to those of a healthy weight, 9 -10 and a third study of hip and knee arthroplasty reported a relative risk of 1.5 for every 5 kg/m 2 increase in body mass index. 11 Independent effects of excess body weight on postoperative venous thromboembolism risk have also been reported following colorectal, [12][13] podiatric, 14 and bariatric 15 surgery.…”

Section: Findings In Relation To Previous Studiesmentioning

confidence: 95%

Body Mass Index, Surgery, and Risk of Venous Thromboembolism in Middle-Aged Women

Parkin

Sweetland²,

Balkwill³

et al. 2012

Circulation

107

View full text Add to dashboard Cite

FRS, for the Million Women Study CollaboratorsBackground-Obesity and surgery are known risk factors for venous thromboembolism (VTE), but there is limited information about the independent effects of obesity on the incidence of postoperative VTE. We linked questionnaire data from the Million Women Study with hospital admission and death records to examine the risk of VTE in relation to body mass index (BMI) both in the absence of surgery and in the first 12 weeks following an operation. Methods and Results-Overall, 1 170 495 women (mean age, 56.1 years) recruited in 1996 to 2001 through the National Health Service Breast Screening Programme in England and Scotland were followed for an average of 6 years, during which time 6438 were admitted to hospital or died of VTE. The adjusted relative risks of VTE increased progressively with increasing BMI and women with a BMI Ն35 kg/m 2 were 3-4 times as likely to develop VTE as those with a BMI 22.5 to 24.9 (relative risk 3.45 [95% CI 3.09 -3.86]). Overweight and obese women were more likely than lean women to be admitted for surgery and also to develop postoperative VTE. During a 12-week period without surgery, the incidence rates of VTE per 1000 women with a BMI Ͻ25 and Ն25 were 0.10 (0.09 -0.10) and 0.19 (0.18 -0.20); the corresponding rates in the 12 weeks following day and inpatient surgery were, respectively, about 4 and 40 times higher. Conclusions-VTE risk increases with increasing BMI and the associated excess risk is much greater after surgery than without surgery. (Circulation. 2012;125:1897-1904.)

show abstract

Section: Findings In Relation To Previous Studiesmentioning

confidence: 95%

Body Mass Index, Surgery, and Risk of Venous Thromboembolism in Middle-Aged Women

Parkin

Sweetland²,

Balkwill³

et al. 2012

Circulation

107

View full text Add to dashboard Cite

show abstract

“…The ACCP practice guidelines suggest increasing the dose of chemical thromboprophylaxis agent for the prevention of VTE in obese patients [14]; however, recommendations for VTE prophylaxis in obese patients are not clear as limited prospective trials have been conducted in this patient subset of the population [3]. Given the alarming rise in the prevalence of obesity in our country, an understanding of optimal UFH dosing regimen in prevention of VTE is crucial.…”

Section: Discussionmentioning

confidence: 99%

“…Critically ill patients requiring admission into the Medical and Surgical Intensive Care Units (MICU and SICU) have at least one risk factor for VTE that may persist for several weeks after discharge [2,3]. The incidence of pulmonary embolism (PE) in the United States is estimated to be 1 in 1000 patients per year, accounting for 200,000 to 300,000 hospitalizations annually [4,5].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Unfractionated Heparin Dosing for Thromboprophylaxis using Anti-Xa Levels in Obese Critically Ill Patients: A Retrospective Study

Cagliani¹,

Nio²,

Wu³

et al. 2017

Intensive & Crit Care

View full text Add to dashboard Cite

“…Obesity is a pro-inflammatory state, and there are higher intra-abdominal pressures in obese patients, which can lead to the formation of venous thrombosis [23]. Studies show that patients who are obese are at a greater risk for thrombosis as well as in patients who are undergoing bariatric surgery, especially for patient with multiple risk factors [24,25]. Some risk factors for venous thromboembolism development include obesity, abdominal surgery, smoking, varicose veins, use of oral contraceptives, history of venous thromboembolism, age greater than 60 years old, and documented venous insufficiency [24].…”

Section: Discussionmentioning

confidence: 99%

A Sleeve Gastrectomy Complicated by Mesenteric Vein Thrombosis, Abdominal Compartment Syndrome and Pulmonary Emboli: Case Report

Leung¹,

Sorensen²

2015

Int J Biomed

View full text Add to dashboard Cite

Background: Obesity is a growing problem all over the world, including the United States. Single-incision laparoscopic sleeve gastrectomy is a surgery performed for patients who want to lose weight. The number of deaths resulting from thromboembolic complications from bariatric surgeries continues to be of major concern.Case Description: A 38-year-old female was admitted for single incision sleeve gastrectomy and was discharged home three days later. Subsequently she began to have abdominal pain, nausea and vomiting. A CT scan revealed superior mesenteric vein thrombosis with small bowel ischemia, splenic infarction and main and right portal vein branch thrombosis. An exploratory laparotomy demonstrated necrotic bowel due to abdominal compartment syndrome, and an area of small bowel was resected due to internal hernia. Surgical management of the patient during her second hospital stay included a decompressive laparotomy, internal hernia reduction, a small bowel resection.Discussion: Superior mesenteric vein thrombosis can be a life-threatening complication and present with non-specific presentations; thus, it is imperative that it is identified and managed promptly as these cases carry significant morbidity and mortality. Obese patients who undergo bariatric surgery frequently have other co-morbidities; many of which can complicate a case further. Mesenteric vein thrombosis is normally treated with unfractionated or low-molecular-weight heparin. (Int J Bopmed. 2015;5(3):162-166.)

show abstract

Risk of Venous Thromboembolism and Efficacy of Thromboprophylaxis in Hospitalized Obese Medical Patients and in Obese Patients Undergoing Bariatric Surgery

Cited by 139 publications

References 41 publications

Body Mass Index, Surgery, and Risk of Venous Thromboembolism in Middle-Aged Women

Body Mass Index, Surgery, and Risk of Venous Thromboembolism in Middle-Aged Women

Evaluation of Unfractionated Heparin Dosing for Thromboprophylaxis using Anti-Xa Levels in Obese Critically Ill Patients: A Retrospective Study

A Sleeve Gastrectomy Complicated by Mesenteric Vein Thrombosis, Abdominal Compartment Syndrome and Pulmonary Emboli: Case Report

Contact Info

Product

Resources

About