Pulmonary thromboembolism and obesity in forensic pathologic case work
Michael Klintschar1, Kirsten Wöllner2, Lars Hagemeier2
1Institute of Forensic Medicine, Hanover Medical School, Department of Legal Medicine, Carl-Neuberg-Straße 1, 30625, Hannover, Germany. Klintschar.Michael@mh-hannover.de.
Forensic Science, Medicine, and Pathology
|March 21, 2023
Summary
Obesity significantly increases the risk of fatal pulmonary thromboembolism (PE). Conversely, being underweight appears to offer a protective advantage against PE, a finding that warrants further investigation.
Area of Science:
- Forensic Pathology
- Cardiovascular Science
- Obesity Research
Background:
- Pulmonary thromboembolism (PE) is a leading cause of death.
- The association between body weight and PE risk requires further clarification, particularly in forensic contexts.
Purpose of the Study:
- To investigate the relationship between obesity and fatal pulmonary thromboembolism (PE) in autopsy cases.
- To compare the prevalence of different body mass index (BMI) categories in PE fatalities versus controls.
Main Methods:
- A comparative analysis of 328 autopsy cases of fatal PE and 984 age- and sex-matched controls.
- Evaluation of body mass index (BMI) and abdominal subcutaneous adipose tissue measurements.
Main Results:
- Morbidly obese individuals (BMI > 40 or abdominal fat > 4 cm) showed a higher prevalence in the PE group.
- Very slim individuals (BMI < 18.5 or abdominal fat < 3 cm) were less common in the PE group.
- A strong association was observed between being overweight and death from PE.
Conclusions:
- Overweight and obesity are significantly associated with an increased risk of fatal pulmonary thromboembolism.
- Slim individuals appear to have a reduced risk of PE, suggesting a potential protective effect.
- The protective effect in underweight individuals, potentially linked to chronic diseases, presents an unexpected finding.
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