Evaluating Time to In-Hospital Venous Thromboembolism in Obese Patients

J Pharm Pract. 2021 Apr;34(2):190-198. doi: 10.1177/0897190019847002. Epub 2019 Jul 14.

Abstract

Background: Currently, no consensus approach exists for optimal venous thromboembolism (VTE) prophylaxis in obese (BMI ≥30 kg/m2) patients. Time to development of in-hospital VTE is not well studied.

Objective: This study evaluates time to in-hospital VTE in obese patients.

Methods: A single-center, retrospective study evaluated obese patients that developed an in-hospital VTE. Patients were categorized into 3 BMI groups: 30 to 34.9 (group 1), 35 to 39.9 (group 2), and ≥40 (group 3) kg/m2. The primary end point compared time to VTE between the groups.

Results: A total of 246 patients were included, and time to VTE was similar between the groups, 8 (group 1) versus 8 (group 2) versus 9 days (group 3); P = .38. Secondary outcomes showed time to VTE was shorter in acute care versus ICU patients (7.5 vs 10 days; P = .01), nonsurgical versus surgical patients (6 vs 9 days; P = .004), and no prophylaxis versus mechanical plus pharmacologic prophylaxis (4.5 vs 9 days; P < .001).

Conclusions: BMI category did not significantly impact time to in-hospital VTE. This study provides insight into the timing of in-hospital VTE in obese patients. The differences in prophylactic strategies highlight the importance of optimized prophylaxis.

Keywords: anticoagulation; deep vein thrombosis prophylaxis; obese; venous thromboembolism.

MeSH terms

  • Anticoagulants / therapeutic use
  • Hospitals
  • Humans
  • Obesity / complications
  • Obesity / diagnosis
  • Obesity / epidemiology
  • Retrospective Studies
  • Risk Factors
  • Venous Thromboembolism* / diagnosis
  • Venous Thromboembolism* / epidemiology
  • Venous Thromboembolism* / etiology

Substances

  • Anticoagulants