This article is part of Pulmonology Advisor‘s coverage of the CHEST 2018 meeting, taking place in San Antonio, Texas. Our staff will report on medical research related to COPD, critical care medicine, and more conducted by experts in the field. Check back regularly for more news from CHEST 2018.

SAN ANTONIO — Obesity is increasing in people hospitalized for pulmonary embolism, according to a study presented at the CHEST Annual Meeting, held October 6-10, 2018, in San Antonio, Texas. Pulmonary embolism was also more common in obese women and in those younger than 65.


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Using a National Inpatient Sample, researchers gathered information on 1,959,018 individuals with pulmonary embolism. Of these, 16% (n=312,770) were obese. Obesity increased over the time period of the study, from 10.2% to 22.6% between 2002 and 2014. Compared with nonobese individuals, pulmonary embolism was more common in obese individuals who were women (62.1% vs 53%; P ≤.001), black (20% vs 15.5%; P ≤.001), recipients of private insurance (40% vs 32%; P ≤.001), younger than 65 (70.7% vs 49.1%; P ≤.001), had comorbid disorders of pulmonary circulation (11.9% vs 6.9%; P ≤.001), had hypertension (65% vs 50.5%; P ≤.001), and had chronic diseases of the liver (2.5% vs 1.6%; P ≤.001), lung (27.4% vs 23.8%; P ≤.001), and kidney (9% vs 7.5%; P ≤.001).

Among obese individuals, there were higher rates of thrombolytics, mechanical intubation, and cardiogenic shock (P ≤.001 for all). However, those with obesity experienced lower mortality rates than those without (2.2% vs 3.7%; P ≤.001), a trend that was sustained over the 13-year study window.

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Individuals included in this study were ≥18 years of age between 2002 and 2014 and had ICD-9 codes of 415.11, 415.13, or 415.19, which indicated a diagnosis of pulmonary embolism. The Elixhauser comorbidity measure within the National Inpatient Sample database was used to find individuals with obesity.

The researchers concluded that “the mortality in patients with pulmonary embolism was lower in obese patients than in non-obese patients despite getting more thrombolytics and mechanical intubation. Activity of the endocannabinoid system has been proposed as a possible mechanism for the reduced mortality in obese patients.”

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Reference

Khan Z, Srour K, Khan MS, Ahmed TS, Siddiqui N, Assaly R. The impact of obesity on mortality and disease severity in patients with pulmonary embolism in United States: a 13-year national analysis. Presented at: CHEST Annual Meeting 2018; October 6-10, 2018; San Antonio, TX.