Body Mass Index, Surgery, and Risk of Venous Thromboembolism in Middle-Aged Women A Cohort Study
Body Mass Index, Surgery, and Risk of Venous Thromboembolism in Middle-Aged Women A Cohort Study
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DOI：
10.1161/circulationaha.111.063354
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发表时间：
2012-04-17
期刊：
影响因子：
37.8
通讯作者：
Beral, Valerie
中科院分区：
文献类型：
--
作者：
Parkin, Lianne;Sweetland, Sian;Beral, Valerie
肥胖和手术是静脉血栓栓塞（VTE）的已知危险因素，但关于肥胖对术后VTE发生率的独立影响的信息有限。我们将来自百万妇女研究的问卷调查数据与住院和死亡记录联系起来，以检查在没有手术的情况下和手术后前12周内与体重指数（BMI）相关的VTE风险。方法和结果1996年至2001年通过英格兰和苏格兰国家卫生服务乳腺筛查计划招募的6438名患者（平均年龄56.1岁）平均随访6年，在此期间有6438人住院或死于VTE。VTE的校正相对风险随着BMI的增加而逐渐增加，BMI ≥ 35 kg/m2的女性发生VTE的可能性是BMI 22.5 - 24.9的女性的3-4倍（相对风险3.45 [95%CI 3.09-3.86]）。超重和肥胖的妇女比瘦的妇女更容易接受手术，也更容易发生术后静脉血栓栓塞。在未手术的12周期间，每1000名BMI = 25的女性的VTE发生率为0.10（0.09-0.10）和0.19（0.18-0.20）;术后12周和住院手术的相应比率分别为，结论：VTE风险随着BMI的增加而增加，手术后相关的超额风险比不手术的高得多。（循环。2012; 125：1897-1904.）
Background-Obesity and surgery are known risk factors for venous thromboembolism (VTE), but there is limited information about the independent effects of obesity on the incidence of postoperative VTE. We linked questionnaire data from the Million Women Study with hospital admission and death records to examine the risk of VTE in relation to body mass index (BMI) both in the absence of surgery and in the first 12 weeks following an operation.Methods and Results-Overall, 1 170 495 women (mean age, 56.1 years) recruited in 1996 to 2001 through the National Health Service Breast Screening Programme in England and Scotland were followed for an average of 6 years, during which time 6438 were admitted to hospital or died of VTE. The adjusted relative risks of VTE increased progressively with increasing BMI and women with a BMI >= 35 kg/m(2) were 3-4 times as likely to develop VTE as those with a BMI 22.5 to 24.9 (relative risk 3.45 [95% CI 3.09-3.86]). Overweight and obese women were more likely than lean women to be admitted for surgery and also to develop postoperative VTE. During a 12-week period without surgery, the incidence rates of VTE per 1000 women with a BMI = 25 were 0.10 (0.09-0.10) and 0.19 (0.18-0.20); the corresponding rates in the 12 weeks following day and inpatient surgery were, respectively, about 4 and 40 times higher.Conclusions-VTE risk increases with increasing BMI and the associated excess risk is much greater after surgery than without surgery. (Circulation. 2012; 125: 1897-1904.)