Heparin dosing for venous thromboembolism prophylaxis in obese hospitalized patients

An observational study

Asad E Patanwala, Stephanie M. Seaman, Brian J. Kopp, Brian L Erstad

Research output: Contribution to journalArticle

Abstract

Objective: To compare rates of VTE occurrence in obese versus non-obese hospitalized patients who received UFH 5000 units subcutaneously q8 h. Materials and methods: This was a retrospective cohort study conducted in an academic medical center in the United States. Consecutive adult patients who were hospitalized during a 1-year time frame (2015) receiving UFH 5000 units subcutaneously q8 h for VTE prophylaxis. The primary outcome was occurrence of VTE during hospitalization. This was compared between obese (body mass index ≥30 kg/m2) and non-obese (body mass index <30 kg/m2) patients. Secondary outcomes included the occurrence of significant bleeding (i.e. intracranial and gastrointestinal hemorrhage). Results: There were 5110 patients included in the study cohort, with a mean age of 57 ± 18 years; and 54% (n = 2757) were male. A similar proportion of patients in the obese group (n = 11/1673, 0.7%) and non-obese group (n = 19/3437, 0.6%) developed a VTE (difference 0.1%, 95% CI −0.4 to 0.6%, p = 0.70). The incidence of VTE was also low (n = 1/394, 0.3%) in patients with body mass index ≥40 kg/m2. Intracranial bleeding occurred in 3 (0.2%) patients in the obese group and 2 (0.1%) patients in the non-obese group (difference 0.1%, 95% CI −0.1 to 0.3%, p = 0.34). Gastrointestinal bleeding occurred in 6 (0.4%) patients in the obese group and 13 (0.4%) patients in the non-obese group (difference 0%, 95% CI −0.4 to 0.3%, p > 0.99). Conclusions: UFH 5000 units subcutaneously q8 h may be sufficient for prevention of VTE in obese patients.

Original languageEnglish (US)
Pages (from-to)152-156
Number of pages5
JournalThrombosis Research
Volume169
DOIs
StatePublished - Sep 1 2018

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Venous Thromboembolism
Observational Studies
Heparin
Body Mass Index
Hospitalization
Cohort Studies
Retrospective Studies

Keywords

  • Body mass index
  • Hemorrhage
  • Heparin
  • Obesity
  • Venous thromboembolism

ASJC Scopus subject areas

  • Hematology

Cite this

Heparin dosing for venous thromboembolism prophylaxis in obese hospitalized patients : An observational study. / Patanwala, Asad E; Seaman, Stephanie M.; Kopp, Brian J.; Erstad, Brian L.

In: Thrombosis Research, Vol. 169, 01.09.2018, p. 152-156.

Research output: Contribution to journalArticle

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abstract = "Objective: To compare rates of VTE occurrence in obese versus non-obese hospitalized patients who received UFH 5000 units subcutaneously q8 h. Materials and methods: This was a retrospective cohort study conducted in an academic medical center in the United States. Consecutive adult patients who were hospitalized during a 1-year time frame (2015) receiving UFH 5000 units subcutaneously q8 h for VTE prophylaxis. The primary outcome was occurrence of VTE during hospitalization. This was compared between obese (body mass index ≥30 kg/m2) and non-obese (body mass index <30 kg/m2) patients. Secondary outcomes included the occurrence of significant bleeding (i.e. intracranial and gastrointestinal hemorrhage). Results: There were 5110 patients included in the study cohort, with a mean age of 57 ± 18 years; and 54{\%} (n = 2757) were male. A similar proportion of patients in the obese group (n = 11/1673, 0.7{\%}) and non-obese group (n = 19/3437, 0.6{\%}) developed a VTE (difference 0.1{\%}, 95{\%} CI −0.4 to 0.6{\%}, p = 0.70). The incidence of VTE was also low (n = 1/394, 0.3{\%}) in patients with body mass index ≥40 kg/m2. Intracranial bleeding occurred in 3 (0.2{\%}) patients in the obese group and 2 (0.1{\%}) patients in the non-obese group (difference 0.1{\%}, 95{\%} CI −0.1 to 0.3{\%}, p = 0.34). Gastrointestinal bleeding occurred in 6 (0.4{\%}) patients in the obese group and 13 (0.4{\%}) patients in the non-obese group (difference 0{\%}, 95{\%} CI −0.4 to 0.3{\%}, p > 0.99). Conclusions: UFH 5000 units subcutaneously q8 h may be sufficient for prevention of VTE in obese patients.",
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T1 - Heparin dosing for venous thromboembolism prophylaxis in obese hospitalized patients

T2 - An observational study

AU - Patanwala, Asad E

AU - Seaman, Stephanie M.

AU - Kopp, Brian J.

AU - Erstad, Brian L

PY - 2018/9/1

Y1 - 2018/9/1

N2 - Objective: To compare rates of VTE occurrence in obese versus non-obese hospitalized patients who received UFH 5000 units subcutaneously q8 h. Materials and methods: This was a retrospective cohort study conducted in an academic medical center in the United States. Consecutive adult patients who were hospitalized during a 1-year time frame (2015) receiving UFH 5000 units subcutaneously q8 h for VTE prophylaxis. The primary outcome was occurrence of VTE during hospitalization. This was compared between obese (body mass index ≥30 kg/m2) and non-obese (body mass index <30 kg/m2) patients. Secondary outcomes included the occurrence of significant bleeding (i.e. intracranial and gastrointestinal hemorrhage). Results: There were 5110 patients included in the study cohort, with a mean age of 57 ± 18 years; and 54% (n = 2757) were male. A similar proportion of patients in the obese group (n = 11/1673, 0.7%) and non-obese group (n = 19/3437, 0.6%) developed a VTE (difference 0.1%, 95% CI −0.4 to 0.6%, p = 0.70). The incidence of VTE was also low (n = 1/394, 0.3%) in patients with body mass index ≥40 kg/m2. Intracranial bleeding occurred in 3 (0.2%) patients in the obese group and 2 (0.1%) patients in the non-obese group (difference 0.1%, 95% CI −0.1 to 0.3%, p = 0.34). Gastrointestinal bleeding occurred in 6 (0.4%) patients in the obese group and 13 (0.4%) patients in the non-obese group (difference 0%, 95% CI −0.4 to 0.3%, p > 0.99). Conclusions: UFH 5000 units subcutaneously q8 h may be sufficient for prevention of VTE in obese patients.

AB - Objective: To compare rates of VTE occurrence in obese versus non-obese hospitalized patients who received UFH 5000 units subcutaneously q8 h. Materials and methods: This was a retrospective cohort study conducted in an academic medical center in the United States. Consecutive adult patients who were hospitalized during a 1-year time frame (2015) receiving UFH 5000 units subcutaneously q8 h for VTE prophylaxis. The primary outcome was occurrence of VTE during hospitalization. This was compared between obese (body mass index ≥30 kg/m2) and non-obese (body mass index <30 kg/m2) patients. Secondary outcomes included the occurrence of significant bleeding (i.e. intracranial and gastrointestinal hemorrhage). Results: There were 5110 patients included in the study cohort, with a mean age of 57 ± 18 years; and 54% (n = 2757) were male. A similar proportion of patients in the obese group (n = 11/1673, 0.7%) and non-obese group (n = 19/3437, 0.6%) developed a VTE (difference 0.1%, 95% CI −0.4 to 0.6%, p = 0.70). The incidence of VTE was also low (n = 1/394, 0.3%) in patients with body mass index ≥40 kg/m2. Intracranial bleeding occurred in 3 (0.2%) patients in the obese group and 2 (0.1%) patients in the non-obese group (difference 0.1%, 95% CI −0.1 to 0.3%, p = 0.34). Gastrointestinal bleeding occurred in 6 (0.4%) patients in the obese group and 13 (0.4%) patients in the non-obese group (difference 0%, 95% CI −0.4 to 0.3%, p > 0.99). Conclusions: UFH 5000 units subcutaneously q8 h may be sufficient for prevention of VTE in obese patients.

KW - Body mass index

KW - Hemorrhage

KW - Heparin

KW - Obesity

KW - Venous thromboembolism

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