%0 Journal Article
%T Obesity Paradox in Patients With Deep Venous Thrombosis
%A Ayman El-Menyar
%A Hassan Al-Thani
%A Mohammad Asim
%J Clinical and Applied Thrombosis/Hemostasis
%@ 1938-2723
%D 2018
%R 10.1177/1076029617727858
%X We aimed to investigate the association between obesity and deep venous thrombosis (DVT) in a country with a high prevalence of obesity. This is a retrospective cohort study of patients who presented with DVT between 2008 and 2012. Data were analyzed and compared based on body mass index (BMI), and patients were classified into normal (<25), overweight (¡Ý25 to <30), obese I (30 to <35), obese II (35 to <40), and obese III (¡Ý40). Among 662 patients with DVT, 28% were overweight and 49% were obese. The mean age was 50.3 (16.5) years, and 51% were females. Diabetes mellitus and prior venous thromboembolism were significantly higher among obese patients. History of malignancy was more common in nonobese patients. Protein S and antithrombin III deficiency and hyperhomocysteinemia were more prevalent among morbid obese patients. Also, obese patients had higher incidence of thrombosis in the distal veins (P = .03). Warfarin use and long-term therapy were more frequent in obese than nonobese. Postthrombotic syndrome was comparable in obese and nonobese groups. Recurrent DVT was higher in obese I (P < .01), whereas mortality rates were greater in nonobese groups (P = .001). Malignancy, diabetes mellitus, and common femoral vein involvement were predictors of mortality, whereas BMI ¡Ý30 was the predictor of survival. Cox regression models showed that after adjusting for age, sex, pulmonary embolism, and duration of warfarin treatment, BMI ¡Ý40 had better survival (hazard ratio: 0.177, 95% confidence interval: 0.045-0.691, P = .013). There is a significant association between obesity and DVT. Obese patients have characteristic risk factors and better survival. This obesity paradox needs further studies to assess its clinical and pharmacotherapeutic implications
%K obesity
%K deep vein thrombosis
%K pulmonary embolism
%K postthrombotic syndrome
%K mortality
%U https://journals.sagepub.com/doi/full/10.1177/1076029617727858