Since 1927, obesity has been thought to be a risk factor for fatalpulmonary embolism (PE). Because of the high proportion of obesity inthe general population, previous studies have not determined whetherobesity is an independent risk factor for PE or deep venous thrombosis(DVT). In an extensive study published in the September issue of TheAmerican Journal of Medicine, researchers from St. Joseph Mercy OaklandHospital, Pontiac, Michigan; Wayne State University, Detroit, Michigan;and Oakland University, Rochester, Michigan; analyzed over 20 years ofpatient records compiled by the National Hospital Discharge Survey(NHDS) to further investigate the potential risk of obesity in venousthromboembolism. The investigators concluded that obesity is a riskfactor for venous thromboembolic disease in men as well as women,particularly those under age 40.
The NHDS is comprehensive in its scope including data on patients ofall races and ages obtained annually from 181,000 to 307,000 sampledpatient abstracts from 400 to 494 non-Federal short-stay hospitals in50 states and the District of Columbia. There were more than 12,000,000obese patients and almost 700,000,000 non-obese patients in the sampleddata.
The relative risk of DVT, comparing obese patients withnon-obese patients, was 2.50. The relative risk of PE was 2.21. Obesefemales had a greater relative risk for DVT than obese males, 2.75versus 2.02. Obesity had the greatest impact on patients aged less than40 years, in whom the relative risk for PE in obese patients was 5.19and the relative risk for DVT was 5.20. In females aged less than 40years, the relative risk for DVT comparing obese with non-obesepatients was 6.10. In males less than 40 years of age, the relativerisk for DVT was 3.71.
Paul D. Stein, MD, writes "Now that we know with certainty thatobesity is a risk factor for PE, particularly in men and women underage 40, the presence of obesity may alert physicians to a possibilityof the diagnosis. The diagnosis of PE is frequently missed even thoughPE is the third most common acute cardiovascular disease aftermyocardial infarction and stroke."
The study, "Obesity as a risk factor in venous thromboembolism" byPaul D. Stein, MD, Afzal Beemath, MD, and Ronald E. Olson, PhD, appearsin The American Journal of Medicine, Volume 118, Number 9 (September 2005), published by Elsevier.
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