Why the study?
The relationship between obesity and mortality in venous thromboembolism remains controversial.
Does obesity reduce early and mid-term mortality in patients with acute pulmonary embolism compared to nonobese, nonunderweight patients?
Does obesity reduce early and mid-term mortality in patients with acute pulmonary embolism compared to nonobese, nonunderweight patients?
Obesity is associated with lower early and mid-term mortality following acute pulmonary embolism, suggesting BMI should be incorporated into prognostic algorithms.
May warrant BMI evaluation in PE risk models; hypothesis-generating for obesity paradox due to observational design.
Background: ) and mortality in venous thromboembolism remains controversial. Objectives: We aimed to compare outcomes after pulmonary embolism (PE) between patients with obesity and nonobese, nonunderweight patients. Methods: Using a multicenter registry of prospectively recorded individual patient data, we compared outcome rates using multivariable logistic or Cox regression for 30-day and 6-month outcomes respectively (etiologic analysis). We assessed the incremental value of adding BMI information on top of the 30-day European Society of Cardiology (ESC) prognostic algorithm (prognostic analysis). Results: (Hosmer-Lemeshow) = .02 vs .13), yielding significant reclassification (ie, 10.3%) based on the observed mortality rates with the ESC model as reference. Findings were confirmed in an external validation using 35,796 patients with PE from the RIETE registry. Conclusion: We present evidence indicating lower early- and mid-term mortality after PE in patients classified as obese based on BMI, compared with nonobese, nonunderweight patients. BMI should likely be incorporated into algorithms or scoring systems for predicting early mortality following PE.
No takes yet. Share an insight, caveat, or question.
Chopard et al. (2025) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: