Prevention of venous thromboembolism in obesity.
Venous thromboembolism (VTE) is a significant cause of morbidity and mortality in hospitalized patients. Where appropriate, evidence-based methods of prophylaxis are implemented and the burden of VTE can be reduced substantially. Obesity, including morbid obesity, is associated with a high risk of VTE and, unfortunately, fixed doses of US FDA-approved anticoagulant regimens, including unfractionated heparins, low-molecular-weight heparins and factor Xa inhibitors, may not provide optimal VTE prophylaxis in these patients. Although the data are still limited, a rapidly growing body of literature and cumulative evidence suggests that anticoagulant dose adjustments in morbidly obese patients may optimize pharmacodynamic activity and reduce VTE risk. With the prevalence of morbid obesity continuing to rise, more high-quality clinical data are needed to better understand the pathobiology of VTE in obesity and provide effective, yet safe, prevention strategies.
University of Utah Department of Internal Medicine, 50 North Medical Drive, Room 4B120, School of Medicine, Salt Lake City, UT 84132, USA.
Andrew L
AL
Freeman
Robert C
RC
Pendleton
Matthew T
MT
Rondina
D000818:Animals; D000925:Anticoagulants / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use; D050110:Bariatric Surgery; D003131:Combined Modality Therapy; D016903:Drug Monitoring; D006801:Humans; D009765:Obesity / Q000150:complications* / Q000503:physiopathology / Q000601:surgery; D009767:Obesity, Morbid / Q000150:complications / Q000503:physiopathology / Q000601:surgery; D011183:Postoperative Complications / Q000517:prevention & control; D017410:Practice Guidelines as Topic; D011655:Pulmonary Embolism / Q000150:complications / Q000453:epidemiology / Q000517:prevention & control; D012307:Risk Factors; D012955:Societies, Medical; D053828:Stockings, Compression; D016306:Vena Cava Filters / Q000009:adverse effects; D054556:Venous Thromboembolism / Q000150:complications* / Q000453:epidemiology / Q000517:prevention & control*; D020246:Venous Thrombosis / Q000150:complications / Q000453:epidemiology / Q000517:prevention & control
D000925:Anticoagulants