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Survival Benefit of Obese Patients With Pulmonary Embolism

Karsten Keller1, Lukas Hobohm2, Thomas Münzel3

  • 1Center for Thrombosis and Hemostasis, University Medical Center Mainz (Johannes Gutenberg-University Mainz), Mainz, Germany.

Mayo Clinic Proceedings
|October 6, 2019
PubMed

Insights

Obesity is linked to lower in-hospital mortality for pulmonary embolism (PE) patients. Underweight patients, however, face increased mortality risks. This study analyzed 345,831 PE inpatients.

Area of Science:

  • Pulmonary Medicine
  • Clinical Research
  • Epidemiology

Background:

  • Pulmonary embolism (PE) is a significant cause of mortality.
  • The impact of body mass index (BMI) on PE outcomes is not fully understood.
  • Investigating obesity and underweight effects on in-hospital outcomes is crucial for patient management.

Purpose of the Study:

  • To determine the association between obesity and underweight with adverse in-hospital outcomes in patients diagnosed with pulmonary embolism (PE).

Main Methods:

  • A retrospective analysis of the German nationwide inpatient database (2011-2014).
  • Inclusion of 345,831 adult inpatients diagnosed with PE (ICD-10 code I26).
  • Stratification of patients into obesity, underweight, and normal/overweight (reference) groups for outcome comparison.

Main Results:

  • Obese patients (8.6%) were younger, more frequently female, had lower cancer rates, and received more reperfusion therapies.
  • Obesity was associated with significantly lower in-hospital mortality (10.9% vs. 15.2%) with an odds ratio (OR) of 0.74 (95% CI, 0.71-0.77), independent of other factors.
  • Underweight patients (0.5%) showed a higher prevalence of cancer and increased mortality (OR, 1.15; 95% CI, 1.00-1.31).

Conclusions:

  • Obesity is paradoxically associated with decreased in-hospital mortality in pulmonary embolism patients.
  • The survival benefit observed in obese PE patients persists regardless of age, sex, comorbidities, or reperfusion treatments.
  • Underweight status in PE patients is linked to poorer outcomes, including higher mortality.
Abstract

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