Risk of VTE increases with BMI.

Obesity and related medical issues are an increasing problem in many countries around the world².

Obesity, including morbid obesity, is associated with a high risk of venous thromboembolism (VTE) - a leading cause of hospital morbidity and mortality3. It is an independent risk factor for sudden, postoperative fatal PE4

In the morbidly obese population that undergoes bariatric surgery, venous thromboembolism has been identified as the leading cause of morbidity and mortality5Venous stasis is also common in obesity; it promotes endothelial activation, predisposing patients to thrombosis6

Increased vigilance required.

Due to the increased risk of VTE faced by this patient population, clinicians need to be especially vigilant in the use of preventative strategies during periods of hospitalisation. Use of pharmacological agents may be challenging; dosing in obese patients can be difficult due to changes in both drug distribution and pharmacokinetics as body composition changes with increased fatty tissue7

Supported by VTE prevention guidelines, clinicians are increasingly using a multi therapy approach adding active compression devices, to pharmaceutical agents, or as a lone therapy for patients at high risk of bleeding8

 

  1. World Health Organisation (2000) Obesity: Preventing and managing the global epidemic [Online]
  2. OECD data, 2012
  3. Spencer FA, Lessard D, Emery C, Reed G, Goldberg RJ. Venous thromboembolism in the outpatient setting. Arch. Intern. Med. 2007;167:1471–1475
  4. International Consensus Guidelines, International Angiology Vol.32-No 2 118-119
  5. Prior HI 2nd, Surg.Endosc.2013 Mar;27(3):843-8
  6. Lopez JA, Chen J. Pathophysiology of venous thrombosis. Thromb. Res. 2009;123:S30–S34
  7. Freeman, Andrew L, Pendleton et al Prevention of venous thromboembolism in obesity, Expert Rev Cardiovasc Ther. Dec 2010;8(12):1711-1721
  8. Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest.2012;141(2) (suppl):7S-47S.