AJM theme issue: Obesity and diabetes
Clinical research study
Obesity as a risk factor in venous thromboembolism

https://doi.org/10.1016/j.amjmed.2005.03.012Get rights and content

Abstract

Purpose

Whether obesity is an independent risk factor for pulmonary embolism or deep venous thrombosis has not been fully determined.

Methods

We used the database of the National Hospital Discharge Survey to further investigate the potential risk of obesity in venous thromboembolic disease.

Results

The relative risk of deep venous thrombosis, comparing obese patients with non-obese patients, was 2.50 (95% confidence interval [CI] = 2.49-2.51). The relative risk of pulmonary embolism was 2.21 (95% CI = 2.20-2.23). Obese females had a greater relative risk for deep venous thrombosis than obese males, 2.75 (95% CI = 2.74-2.76) versus 2.02 (95% CI = 2.01-2.04). Obesity had the greatest impact on both men and women aged less than 40 years.

Conclusion

The data indicate that obesity is a risk factor for venous thromboembolic disease in men as well as women.

Section snippets

Data sources

The number of patients discharged from hospitals with a diagnostic code of obesity between 1979 and 1999 was obtained from the NHDS.13 Among these patients the number with pulmonary embolism or deep venous thrombosis was determined.

The NHDS consists of data obtained annually from 181 000 to 307 000 sampled patient abstracts from 400 to 494 non-Federal short-stay hospitals in 50 states and the District of Columbia.13 The NHDS samples approximately 8% of short-stay non-Federal hospitals and

Results

The proportion of hospitalized patients diagnosed with obesity ranged from 1.4% to 2.4% over the 21-year period of observation. Among hospitalized patients diagnosed with obesity, 91 000 of 12 015 000 (0.76%) had pulmonary embolism. Among hospitalized patients who were not diagnosed with obesity, pulmonary embolism was diagnosed in 2 366 000 of 691 000 000 (0.34%). Deep venous thrombosis was diagnosed in 243 000 of 12 015 000 patients (2.02%) diagnosed with obesity and in 5 524 000 of 691 000 000 patients

Discussion

These data show that obesity is a risk factor for pulmonary embolism and deep venous thrombosis in men as well as women. Obesity seems to be a stronger risk factor in women and in men and in women less than 40 years of age.

An advantage of the NHDS database is its extensive coverage of all races, ages, and regions of the United States. A disadvantage is that the basis for the diagnosis of obesity was not defined. Even so, the proportion of hospitalized patients diagnosed with obesity was within

Acknowledgment

Julia Sanchez, MD, and Tehmina Siddiqui, MD, assisted with this investigation.

References (16)

  • S.Z. Goldhaber et al.

    Risk factors for pulmonary embolism. The Framingham Study

    Am J Med.

    (1983)
  • A.M. Snell

    The relation of obesity to fatal postoperative pulmonary embolism

    Arch Surg.

    (1927)
  • J.A. Heit et al.

    The epidemiology of venous thromboembolism in the community

    Thromb Haemost.

    (2001)
  • F.A. Anderson et al.

    A population-based perspective of the hospital incidence and case-fatality rates of deep vein thrombosis and pulmonary embolism. The Worcester DVT Study

    Arch Intern Med.

    (1991)
  • F.A. Anderson et al.

    The prevalence of risk factors for venous thromboembolism among hospital patients

    Arch Intern Med.

    (1992)
  • A.A. Hedley et al.

    Prevalence of overweight and obesity among US children, adolescents, and adults, 1999-2002

    JAMA

    (2004)
  • S.Z. Goldhaber et al.

    A prospective study of risk factors for pulmonary embolism in women

    JAMA

    (1997)
  • M. Abdollahi et al.

    Obesityrisk of venous thrombosis and the interaction with coagulation factor levels and oral contraceptive use

    Thromb Haemost.

    (2003)
There are more references available in the full text version of this article.

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