Body mass index predicts major bleeding risks in patients on warfarin
Despite the lack of an optimum dosing strategy in obese patients, warfarin remains the most commonly used anticoagulant. Body mass index (BMI) >30 has been linked to increased time to obtain a therapeutic international normalized ratio on initiation of warfarin as well as higher maintenance dose....
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| Veröffentlicht in: | Journal of thrombosis and thrombolysis 2015-11, Vol.40 (4), p.494-498 |
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| creator | Ogunsua, Adedotun A. Touray, Sunkaru Lui, Justin K. Ip, Tiffany Escobar, Jorge V. Gore, Joel |
| description | Despite the lack of an optimum dosing strategy in obese patients, warfarin remains the most commonly used anticoagulant. Body mass index (BMI) >30 has been linked to increased time to obtain a therapeutic international normalized ratio on initiation of warfarin as well as higher maintenance dose. Despite higher dosage requirements, few studies have examined the relationship between warfarin and bleeding events in obese individuals. We examined the performance of BMI in predicting the incidence of bleeding at an anticoagulation clinic (ACC) over a 1 year period. Eight hundred and sixty-three patients followed in the ACC over a 1 year period were evaluated for bleeds in relation to BMI [defined as weight (kg)/height (m
2
)]. Seventy-one of the 863 patients had a bleeding event (8.2 %); mean age 69.5 years and 44 % females. BMI categories were normal weight (21 %), overweight (38 %), obese class I (21 %), II (9 %), and III (11.3 %), respectively. Prevalence of major and minor bleeding events were 4.4 and 3.8 %, respectively. In univariate analyses, hazard ratio (HR) for major bleeding risks increases with higher obesity categories (HR 1.3, 1.85, and 1.93 for classes I, II, III, respectively). In multivariable adjusted model obesity classes II and III significantly increased the risk of major bleeds (HR 1.84, p |
| doi_str_mv | 10.1007/s11239-015-1226-2 |
| format | Article |
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2
)]. Seventy-one of the 863 patients had a bleeding event (8.2 %); mean age 69.5 years and 44 % females. BMI categories were normal weight (21 %), overweight (38 %), obese class I (21 %), II (9 %), and III (11.3 %), respectively. Prevalence of major and minor bleeding events were 4.4 and 3.8 %, respectively. In univariate analyses, hazard ratio (HR) for major bleeding risks increases with higher obesity categories (HR 1.3, 1.85, and 1.93 for classes I, II, III, respectively). In multivariable adjusted model obesity classes II and III significantly increased the risk of major bleeds (HR 1.84, p < 0.001). Bleeding risk is higher in obese compared to normal weight individuals who are on warfarin. These results suggests that BMI plays a role in bleeding events in patients on warfarin.</description><identifier>ISSN: 0929-5305</identifier><identifier>EISSN: 1573-742X</identifier><identifier>DOI: 10.1007/s11239-015-1226-2</identifier><identifier>PMID: 26076985</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Adult ; Age Factors ; Aged ; Aged, 80 and over ; Body Mass Index ; Cardiology ; Female ; Hematology ; Hemorrhage - chemically induced ; Hemorrhage - epidemiology ; Humans ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Obesity ; Retrospective Studies ; Risk Factors ; Sex Factors ; Warfarin - administration & dosage ; Warfarin - adverse effects</subject><ispartof>Journal of thrombosis and thrombolysis, 2015-11, Vol.40 (4), p.494-498</ispartof><rights>Springer Science+Business Media New York 2015</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c508t-a217a704b2ae51825121fe12dcceefc6d1b1bb06d2c3b88f91c95093bc2dc53a3</citedby><cites>FETCH-LOGICAL-c508t-a217a704b2ae51825121fe12dcceefc6d1b1bb06d2c3b88f91c95093bc2dc53a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s11239-015-1226-2$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s11239-015-1226-2$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,778,782,27907,27908,41471,42540,51302</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26076985$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ogunsua, Adedotun A.</creatorcontrib><creatorcontrib>Touray, Sunkaru</creatorcontrib><creatorcontrib>Lui, Justin K.</creatorcontrib><creatorcontrib>Ip, Tiffany</creatorcontrib><creatorcontrib>Escobar, Jorge V.</creatorcontrib><creatorcontrib>Gore, Joel</creatorcontrib><title>Body mass index predicts major bleeding risks in patients on warfarin</title><title>Journal of thrombosis and thrombolysis</title><addtitle>J Thromb Thrombolysis</addtitle><addtitle>J Thromb Thrombolysis</addtitle><description>Despite the lack of an optimum dosing strategy in obese patients, warfarin remains the most commonly used anticoagulant. Body mass index (BMI) >30 has been linked to increased time to obtain a therapeutic international normalized ratio on initiation of warfarin as well as higher maintenance dose. Despite higher dosage requirements, few studies have examined the relationship between warfarin and bleeding events in obese individuals. We examined the performance of BMI in predicting the incidence of bleeding at an anticoagulation clinic (ACC) over a 1 year period. Eight hundred and sixty-three patients followed in the ACC over a 1 year period were evaluated for bleeds in relation to BMI [defined as weight (kg)/height (m
2
)]. Seventy-one of the 863 patients had a bleeding event (8.2 %); mean age 69.5 years and 44 % females. BMI categories were normal weight (21 %), overweight (38 %), obese class I (21 %), II (9 %), and III (11.3 %), respectively. Prevalence of major and minor bleeding events were 4.4 and 3.8 %, respectively. In univariate analyses, hazard ratio (HR) for major bleeding risks increases with higher obesity categories (HR 1.3, 1.85, and 1.93 for classes I, II, III, respectively). In multivariable adjusted model obesity classes II and III significantly increased the risk of major bleeds (HR 1.84, p < 0.001). Bleeding risk is higher in obese compared to normal weight individuals who are on warfarin. These results suggests that BMI plays a role in bleeding events in patients on warfarin.</description><subject>Adult</subject><subject>Age Factors</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Body Mass Index</subject><subject>Cardiology</subject><subject>Female</subject><subject>Hematology</subject><subject>Hemorrhage - chemically induced</subject><subject>Hemorrhage - epidemiology</subject><subject>Humans</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Obesity</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Sex Factors</subject><subject>Warfarin - administration & dosage</subject><subject>Warfarin - adverse effects</subject><issn>0929-5305</issn><issn>1573-742X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp10MtKxDAUBuAgijOOPoAbKbhxUz0nbZpmqcN4AcGNgruQpunQsTeTFp23N6WjiOAqJPnOn_ATcopwiQD8yiHSSISALERKk5DukTkyHoU8pq_7ZA6CipBFwGbkyLkNAAgB9JDMaAI8ESmbk9VNm2-DWjkXlE1uPoPOmrzUvfNnm9YGWWX8vlkHtnRvowk61Zem8aBtgg9lC2XL5pgcFKpy5mS3LsjL7ep5eR8-Pt09LK8fQ80g7UNFkSsOcUaVYZhShhQLgzTX2phCJzlmmGWQ5FRHWZoWArVgIKJMe8IiFS3IxZTb2fZ9MK6Xdem0qSrVmHZwEjnyOI0FMk_P_9BNO9jG_25UCU8jQPQKJ6Vt65w1hexsWSu7lQhy7FhOHUvfsRw7ltTPnO2Sh6w2-c_Ed6ke0Ak4f9Wsjf319L-pX2fmhjM</recordid><startdate>20151101</startdate><enddate>20151101</enddate><creator>Ogunsua, Adedotun A.</creator><creator>Touray, Sunkaru</creator><creator>Lui, Justin K.</creator><creator>Ip, Tiffany</creator><creator>Escobar, Jorge V.</creator><creator>Gore, Joel</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope></search><sort><creationdate>20151101</creationdate><title>Body mass index predicts major bleeding risks in patients on warfarin</title><author>Ogunsua, Adedotun A. ; Touray, Sunkaru ; Lui, Justin K. ; Ip, Tiffany ; Escobar, Jorge V. ; Gore, Joel</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c508t-a217a704b2ae51825121fe12dcceefc6d1b1bb06d2c3b88f91c95093bc2dc53a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Adult</topic><topic>Age Factors</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Body Mass Index</topic><topic>Cardiology</topic><topic>Female</topic><topic>Hematology</topic><topic>Hemorrhage - chemically induced</topic><topic>Hemorrhage - epidemiology</topic><topic>Humans</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Obesity</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Sex Factors</topic><topic>Warfarin - administration & dosage</topic><topic>Warfarin - adverse effects</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ogunsua, Adedotun A.</creatorcontrib><creatorcontrib>Touray, Sunkaru</creatorcontrib><creatorcontrib>Lui, Justin K.</creatorcontrib><creatorcontrib>Ip, Tiffany</creatorcontrib><creatorcontrib>Escobar, Jorge V.</creatorcontrib><creatorcontrib>Gore, Joel</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Neurosciences Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of thrombosis and thrombolysis</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ogunsua, Adedotun A.</au><au>Touray, Sunkaru</au><au>Lui, Justin K.</au><au>Ip, Tiffany</au><au>Escobar, Jorge V.</au><au>Gore, Joel</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Body mass index predicts major bleeding risks in patients on warfarin</atitle><jtitle>Journal of thrombosis and thrombolysis</jtitle><stitle>J Thromb Thrombolysis</stitle><addtitle>J Thromb Thrombolysis</addtitle><date>2015-11-01</date><risdate>2015</risdate><volume>40</volume><issue>4</issue><spage>494</spage><epage>498</epage><pages>494-498</pages><issn>0929-5305</issn><eissn>1573-742X</eissn><abstract>Despite the lack of an optimum dosing strategy in obese patients, warfarin remains the most commonly used anticoagulant. Body mass index (BMI) >30 has been linked to increased time to obtain a therapeutic international normalized ratio on initiation of warfarin as well as higher maintenance dose. Despite higher dosage requirements, few studies have examined the relationship between warfarin and bleeding events in obese individuals. We examined the performance of BMI in predicting the incidence of bleeding at an anticoagulation clinic (ACC) over a 1 year period. Eight hundred and sixty-three patients followed in the ACC over a 1 year period were evaluated for bleeds in relation to BMI [defined as weight (kg)/height (m
2
)]. Seventy-one of the 863 patients had a bleeding event (8.2 %); mean age 69.5 years and 44 % females. BMI categories were normal weight (21 %), overweight (38 %), obese class I (21 %), II (9 %), and III (11.3 %), respectively. Prevalence of major and minor bleeding events were 4.4 and 3.8 %, respectively. In univariate analyses, hazard ratio (HR) for major bleeding risks increases with higher obesity categories (HR 1.3, 1.85, and 1.93 for classes I, II, III, respectively). In multivariable adjusted model obesity classes II and III significantly increased the risk of major bleeds (HR 1.84, p < 0.001). Bleeding risk is higher in obese compared to normal weight individuals who are on warfarin. These results suggests that BMI plays a role in bleeding events in patients on warfarin.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>26076985</pmid><doi>10.1007/s11239-015-1226-2</doi><tpages>5</tpages></addata></record> |
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| subjects | Adult Age Factors Aged Aged, 80 and over Body Mass Index Cardiology Female Hematology Hemorrhage - chemically induced Hemorrhage - epidemiology Humans Male Medicine Medicine & Public Health Middle Aged Obesity Retrospective Studies Risk Factors Sex Factors Warfarin - administration & dosage Warfarin - adverse effects |
| title | Body mass index predicts major bleeding risks in patients on warfarin |
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