Impact of obesity on clinical outcomes in patients with high-risk pulmonary embolism: A comparative analysis
Background: Pulmonary embolism (PE) is a life-threatening cardiovascular condition with increasing global incidence. Obesity is a significant risk factor for PE, although its reported relationship with outcomes is inconsistent. This study aimed to investigate the impact of obesity on clinical outcom...
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| Format: | Article |
| Language: | English |
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Elsevier
2025-06-01
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| Series: | International Journal of Cardiology: Heart & Vasculature |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352906725000855 |
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| author | Ziv Shachar Marlon V. Gatuz Adam Folman Maguli S. Barel Rami Abu-Fanne Dmitry Abramov Mamas A. Mamas Ariel Roguin Ofer Kobo |
| author_facet | Ziv Shachar Marlon V. Gatuz Adam Folman Maguli S. Barel Rami Abu-Fanne Dmitry Abramov Mamas A. Mamas Ariel Roguin Ofer Kobo |
| author_sort | Ziv Shachar |
| collection | DOAJ |
| description | Background: Pulmonary embolism (PE) is a life-threatening cardiovascular condition with increasing global incidence. Obesity is a significant risk factor for PE, although its reported relationship with outcomes is inconsistent. This study aimed to investigate the impact of obesity on clinical outcomes in patients with high-risk PE. Methods: We conducted a retrospective analysis of US adult patients hospitalized with high-risk PE from 2016 to 2019 using the National Inpatient Sample database. Patients were categorized into three groups based on BMI: non-obese, obese (30 to < 40 kg/m2), and severely obese (≥40 kg/m2). We compared baseline characteristics, in-hospital procedures, and outcomes among these groups. Multivariable logistic regression models assessed the relationship between obesity levels and in-hospital outcomes. Results: Of 752,660 patients with PE, 29,610 (3.9 %) were classified as high-risk. The distribution among BMI categories was: non-obese (77.1 %), obese (8.8 %), and severely obese (14.1 %). Severely obese patients were younger (mean age 55.7 vs. 66.1 years for non-obese, p < 0.001) and more likely to be female (63.2 % vs. 51.4 % for non-obese, p < 0.001). After adjustment, obese and severely obese patients had lower odds of in-hospital mortality (obese: aOR 0.50, p < 0.001; severely obese: aOR 0.69, p < 0.001) and major adverse cardiovascular and cerebrovascular events (obese: aOR 0.50, p < 0.001; severely obese: aOR 0.72, p < 0.001). Conclusion: Our study revealed an “obesity paradox” in high-risk PE patients, with obese and severely obese individuals showing lower mortality and fewer complications despite higher comorbidity rates. These findings emphasize the need for tailored risk assessment and treatment strategies in obese patients with high-risk PE. |
| format | Article |
| id | doaj-art-962f704f9ffc441ebedd70fd803b922d |
| institution | Kabale University |
| issn | 2352-9067 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | International Journal of Cardiology: Heart & Vasculature |
| spelling | doaj-art-962f704f9ffc441ebedd70fd803b922d2025-08-20T03:49:46ZengElsevierInternational Journal of Cardiology: Heart & Vasculature2352-90672025-06-015810168210.1016/j.ijcha.2025.101682Impact of obesity on clinical outcomes in patients with high-risk pulmonary embolism: A comparative analysisZiv Shachar0Marlon V. Gatuz1Adam Folman2Maguli S. Barel3Rami Abu-Fanne4Dmitry Abramov5Mamas A. Mamas6Ariel Roguin7Ofer Kobo8Rappaport Faculty of Medicine, Technion Israel Institute of Technology, Haifa, IsraelDepartment of Cardiology, Hillel Yaffe Medical Center, Hadera, Israel; Department of Internal Medicine, Ilocos Sur Medical Center, Candon City, PhilippinesDepartment of Cardiology, Hillel Yaffe Medical Center, Hadera, IsraelDepartment of Cardiology, Hillel Yaffe Medical Center, Hadera, IsraelRappaport Faculty of Medicine, Technion Israel Institute of Technology, Haifa, Israel; Department of Cardiology, Hillel Yaffe Medical Center, Hadera, IsraelDepartment of Cardiology, Linda Loma University Health, Linda Loma, USAKeele Cardiovascular Research Group, Keele University, UK; National Institute for Health and Care Research (NIHR) Birmingham Biomedical Research Centre, UKRappaport Faculty of Medicine, Technion Israel Institute of Technology, Haifa, Israel; Department of Cardiology, Hillel Yaffe Medical Center, Hadera, IsraelRappaport Faculty of Medicine, Technion Israel Institute of Technology, Haifa, Israel; Department of Cardiology, Hillel Yaffe Medical Center, Hadera, Israel; Keele Cardiovascular Research Group, Keele University, UK; Corresponding author at: Department of Cardiology, Hillel Yaffe Hospital, Hadera, Israel.Background: Pulmonary embolism (PE) is a life-threatening cardiovascular condition with increasing global incidence. Obesity is a significant risk factor for PE, although its reported relationship with outcomes is inconsistent. This study aimed to investigate the impact of obesity on clinical outcomes in patients with high-risk PE. Methods: We conducted a retrospective analysis of US adult patients hospitalized with high-risk PE from 2016 to 2019 using the National Inpatient Sample database. Patients were categorized into three groups based on BMI: non-obese, obese (30 to < 40 kg/m2), and severely obese (≥40 kg/m2). We compared baseline characteristics, in-hospital procedures, and outcomes among these groups. Multivariable logistic regression models assessed the relationship between obesity levels and in-hospital outcomes. Results: Of 752,660 patients with PE, 29,610 (3.9 %) were classified as high-risk. The distribution among BMI categories was: non-obese (77.1 %), obese (8.8 %), and severely obese (14.1 %). Severely obese patients were younger (mean age 55.7 vs. 66.1 years for non-obese, p < 0.001) and more likely to be female (63.2 % vs. 51.4 % for non-obese, p < 0.001). After adjustment, obese and severely obese patients had lower odds of in-hospital mortality (obese: aOR 0.50, p < 0.001; severely obese: aOR 0.69, p < 0.001) and major adverse cardiovascular and cerebrovascular events (obese: aOR 0.50, p < 0.001; severely obese: aOR 0.72, p < 0.001). Conclusion: Our study revealed an “obesity paradox” in high-risk PE patients, with obese and severely obese individuals showing lower mortality and fewer complications despite higher comorbidity rates. These findings emphasize the need for tailored risk assessment and treatment strategies in obese patients with high-risk PE.http://www.sciencedirect.com/science/article/pii/S2352906725000855Pulmonary embolismObesityRisk factorsOutcomes |
| spellingShingle | Ziv Shachar Marlon V. Gatuz Adam Folman Maguli S. Barel Rami Abu-Fanne Dmitry Abramov Mamas A. Mamas Ariel Roguin Ofer Kobo Impact of obesity on clinical outcomes in patients with high-risk pulmonary embolism: A comparative analysis International Journal of Cardiology: Heart & Vasculature Pulmonary embolism Obesity Risk factors Outcomes |
| title | Impact of obesity on clinical outcomes in patients with high-risk pulmonary embolism: A comparative analysis |
| title_full | Impact of obesity on clinical outcomes in patients with high-risk pulmonary embolism: A comparative analysis |
| title_fullStr | Impact of obesity on clinical outcomes in patients with high-risk pulmonary embolism: A comparative analysis |
| title_full_unstemmed | Impact of obesity on clinical outcomes in patients with high-risk pulmonary embolism: A comparative analysis |
| title_short | Impact of obesity on clinical outcomes in patients with high-risk pulmonary embolism: A comparative analysis |
| title_sort | impact of obesity on clinical outcomes in patients with high risk pulmonary embolism a comparative analysis |
| topic | Pulmonary embolism Obesity Risk factors Outcomes |
| url | http://www.sciencedirect.com/science/article/pii/S2352906725000855 |
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