Can We Better Protect Hospitalized Patients With Obesity From Venous Thromboembolism? – RPTH Journal
RPTH Journal shared a post on LinkedIn about a recent article by Walter Agenoet et al, adding:
”Can we better protect hospitalized patients with obesity from venous thromboembolism?
Patients with obesity hospitalized for acute medical illness face a substantial risk of venous thromboembolism (VTE), yet optimal thromboprophylaxis strategies remain uncertain.
In this large real-world analysis of 58,186 hospitalized adults receiving enoxaparin, researchers evaluated treatment patterns, clinical outcomes, and predictors of VTE and major bleeding (MB).
More than half of patients (56.9 percent) received high-dose enoxaparin (more than 40 mg/day), but prophylaxis was typically shorter than hospitalization (median 3 days compared with 4 days), and only 1.3 percent received post-discharge enoxaparin.
Despite prophylaxis, the cumulative 90-day incidence reached 3.2 percent for venous thromboembolism compared with 1.8 percent for major bleeding, suggesting that thrombotic risk outweighed bleeding risk in this population.
The highest venous thromboembolism risk occurred in patients hospitalized with cancer (7.8 percent), while a history of venous thromboembolism emerged as the strongest predictor of recurrent thrombosis (hazard ratio 4.1). A history of major bleeding was the strongest predictor of future major bleeding (hazard ratio 2.8). These findings support more individualized risk assessment, particularly for patients with cancer, severe obesity, or prior venous thromboembolism.
As obesity continues to rise worldwide, optimizing the dose, duration, and personalization of thromboprophylaxis remains an important clinical challenge.
Title: Venous thromboembolic and bleeding risk in population with obesity hospitalized for an acute medical illness receiving enoxaparin for thromboprophylaxis
Authors: Walter Ageno, Juan I. Arcelus, Christine Stroh, Yasmina Djoudi, Mohamed Abdel-Moneim, Irfan Khan, Ekaterina Ponomareva, Marc Carrier
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