Figures
- FIGURE 1
Association between body mass index (BMI) categories and clinical and radiological parameters with BMI 18.5–24.9 kg·m−2 as a reference. Odds ratios for a) N-terminal pro-brain natriuretic peptide, b) high-risk simplified pulmonary embolism severity index score, c) pulmonary trunk >29 mm, d) right/left ventricular diameter ratio >1.0, e) central embolism and d) concurrent deep venous thrombosis are shown. Error bars present 95% confidence intervals.
- FIGURE 2
Association between body mass index (BMI) categories and outcomes with BMI 18.5–24.9 kg·m−2 as reference. Odds ratios for a) death, b) recurrent venous thromboembolism, c) hospitalisation, d) bleeding and e) all adverse events are shown. Error bars represent 95% confidence intervals.
Tables
- TABLE 1
Baseline characteristics
Total BMI <18.5 kg·m−2 BMI 18.5–24.99 kg·m−2 BMI >25 kg·m−2 Included 1911 (100%) 29 (1.5%) 493 (25.8%) 1389 (72.7%) Clinical Age years 56.9±16.6 56.6±23.9 55.7±18.8 57.3±15.5 Weight kg 84.6±20.1 49.9±8.0 66.7±10.0 91.7±18.2 SBP mmHg 128±16.5 118±15.4 126±16.8 129±16.3 DBP mmHg 76±11.0 69±8.8 74±10.6 77±11.1 Heart rate beats per min 80±14.2 85±10.0 80±14.7 80±14.1 Age <50 years 629 (32.9%) 11 (37.9%) 190 (38.5%) 428 (30.8%) Age >65 years 696 (36.4%) 14 (48.3%) 183 (37.1%) 499 (35.9%) Weight <60 kg 187 (9.8%) 24 (82.8%) 144 (29.2%) 19 (1.4%) Current alcohol use 741 (38.8%) 10 (34.5%) 199 (40.4%) 532 (38.3%) Smoking 834 (43.6%) 15 (51.7%) 235 (47.7%) 584 (42.0%) NT-proBNP >600 pg·mL−1 504 (27.3%) 12 (42.9%) 115 (23.9%) 377 (28.2%) sPESI# high risk ≥1 1028 (53.8%) 21 (72.4%) 251 (50.9%) 756 (54.4%) Unprovoked PE 1266 (66.2%) 21 (72.4%) 327 (66.3%) 918 (66.1%) Concurrent DVT 447 (23.4%) 3 (10.3%) 102 (20.7%) 342 (24.6%) Risk factors Recent surgery, trauma or immobilisation 364 (19.0%) 5 (17.2%) 76 (15.4%) 283 (20.4%) Sitting >4 h 182 (9.5%) 1 (3.4%) 58 (11.8%) 123 (8.9%) Oestrogen drug use 193 (10.1%) 8 (27.6%) 73 (14.8%) 112 (8.1%) Previous DVT/PE 405 (21.2%) 1 (3.4%) 85 (17.2%) 319 (23.0%) Thrombophilia 94 (4.9%) 1 (3.4%) 32 (6.5%) 61 (4.4%) Concomitant disease history Hypertension 793 (41.5%) 11 (37.9%) 136 (27.6%) 646 (46.5%) Diabetes 194 (10.2%) 3 (10.3%) 18 (3.7%) 173 (12.5%) Cardiovascular disease 306 (16.0%) 6 (20.7%) 82 (16.6%) 218 (15.7%) Chronic heart failure 34 (1.8%) 2 (6.9%) 6 (1.2%) 26 (1.8%) Cerebrovascular disease 71 (3.7%) 1 (3.4%) 20 (4.1%) 50 (3.6%) Stroke 34 (1.8%) 1 (3.4%) 11 (2.2%) 22 (1.6%) Renal disease 128 (6.7%) 2 (6.9%) 30 (6.1%) 96 (6.9%) Hepatic disease 207 (10.8%) 3 (10.3%) 47 (9.5%) 157 (10.8%) Pulmonary disease 391 (20.5%) 12 (41.4%) 91 (18.5%) 288 (20.7%) COPD 100 (5.2%) 7 (24.1%) 35 (7.1%) 58 (4.2%) Pulmonary hypertension 43 (2.3%) 2 (6.9%) 6 (1.2%) 35 (2.5%) Cancer 221 (11.6%) 6 (20.7%) 65 (13.2%) 150 (10.8%) Data are presented as mean±sd unless otherwise stated. SBP: systolic blood pressure; DBP: diastolic blood pressure; NT-proBNP: N-terminal pro-brain natriuretic peptide; sPESI: simplified Pulmonary Embolism Severity Index; PE: pulmonary embolus; DVT: deep vein thrombosis. #: item on oxygen considered positive if patient needed oxygen administration.
- TABLE 2
Distribution of patients according to World Health Organization body mass index (BMI) categories (N=1911)
BMI <18.5 kg·m−2 29 (1.5%) BMI 18.5–24.9 kg·m−2 493 (25.8%) BMI 25–29.9 kg·m−2 717 (37.5%) BMI 30–34.9 kg·m−2 414 (21.7%) BMI 35–39.9 kg·m−2 154 (8.1%) BMI ≥40 kg·m−2 104 (5.4%) Complete 1950# #: body height was not available in 39 (2.0%) out of 1950 patients so in these patients, BMI could not be calculated.
- TABLE 3
Odds ratios for clinical and radiological parameters and outcomes according to World Health Organization body mass index (BMI) categories
Patients Unadjusted OR (95% CI) Adjusted# OR (95% CI) Clinical and radiological parameters NT-proBNP >600 pg·mL−1 BMI <18.5 kg·m−2 12 (42.8%) 2.38 (1.09–5.18) 2.62 (1.10–6.23) BMI 18.5–24.9 kg·m−2 115 (24.0%) 1 (ref.) 1 (ref.) BMI 25.0–29.9 kg·m−2 162 (23.4%) 0.97 (0.74–1.28) 0.98 (0.74–1.31) BMI 30.0–34.9 kg·m−2 124 (31.2%) 1.44 (1.07–1.94) 1.41 (1.03–1.93) BMI 35.0–39.9 kg·m−2 50 (34.0%) 1.64 (1.10–2.44) 1.62 (91.06–2.48) BMI >40 kg·m−2 41 (41.0%) 2.21 (1.41–3.46) 2.90 (1.79–4.70) sPESI high risk BMI <18.5 kg·m−2 21 (72.4%) 2.52 (1.10–5.80) 2.49 (1.08–5.75) BMI 18.5–24.9 kg·m−2 251 (51.0%) 1 (ref.) 1 (ref.) BMI 25.0–29.9 kg·m−2 375 (52.4%) 1.06 (0.84–1.33) 1.11 (0.88–1.40) BMI 30.0–34.9 kg·m−2 230 (55.7%) 1.21 (0.93–1.57) 1.23 (0.95–1.60) BMI 35.0–39.9 kg·m−2 84 (54.5%) 1.15 (0.80–1.66) 1.13 (0.78–1.62) BMI >40 kg·m−2 66 (63.5%) 1.67 (1.08–2.58) 1.55 (1.00–2.41) Pulmonary trunk >29 mm BMI <18.5 kg·m−2 8 (27.6%) 1.39 (0.60–3.22) 1.36 (0.56–3.28) BMI 18.5–24.9 kg·m−2 106 (21.5%) 1 (ref.) 1 (ref.) BMI 25.0–29.9 kg·m−2 232 (32.4%) 1.75 (1.34–2.28) 1.66 (1.27–2.19) BMI 30.0–34.9 kg·m−2 168 (40.7%) 2.50 (1.87–3.34) 2.44 (1.81–3.28) BMI 35.0–39.9 kg·m−2 59 (38.3%) 2.26 (1.53–3.34) 2.37 (1.59–3.53) BMI >40 kg·m−2 49 (47.1%) 3.24 (2.09–5.04) 4.32 (2.73–6.83) RV/LV >1.0 BMI <18.5 kg·m−2 4 (13.8%) 0.45 (0.15–1.31) 0.40 (0.13–1.12) BMI 18.5–24.9 kg·m−2 130 (26.4%) 1 (ref.) 1 (ref.) BMI 25.0–29.9 kg·m−2 231 (32.3%) 1.33 (1.03–1.71) 1.31 (1.01–1.70) BMI 30.0–34.9 kg·m−2 157 (38.0%) 1.71 (1.29–2.27) 1.66 (1.24–2.21) BMI 35.0–39.9 kg·m−2 48 (31.2%) 1.26 (0.85–1.88) 1.24 (0.83–1.85) BMI >40 kg·m−2 41 (39.4%) 1.81 (1.17–2.81) 2.12 (1.34–3.33) Central embolus BMI <18.5 kg·m−2 7 (24.1%) 0.78 (0.33–1.86) 0.75 (0.31–1.82) BMI 18.5–24.9 kg·m−2 143 (29.1%) 1 (ref.) 1 (ref.) BMI 25.0–29.9 kg·m−2 234 (32.7%) 1.19 (1.19–0.92) 1.17 (0.91–1.50) BMI 30.0–34.9 kg·m−2 167 (40.4%) 1.66 (1.26–2.19) 1.61 (1.22–2.13) BMI 35.0–39.9 kg·m−2 62 (40.3%) 1.65 (1.30–2.40) 1.61 (1.10–2.36) BMI >40 kg·m−2 49 (47.1%) 2.17 (1.41–3.35) 2.34 (1.51–3.62) Concurrent DVT BMI <18.5 kg·m−2 3 (10.3%) 0.44 (0.13–1.49) 0.45 (0.13–1.52) BMI 18.5–24.9 kg·m−2 102 (20.7%) 1 (ref.) 1 (ref.) BMI 25.0–29.9 kg·m−2 170 (23.7%) 1.19 (0.90–1.57) 1.15 (0.87–1.52) BMI 30.0–34.9 kg·m−2 121 (29.3%) 1.58 (1.17–2.15) 1.57 (1.16–2.14) BMI 35.0–39.9 kg·m−2 36 (23.4%) 1.17 (0.76–1.80) 1.20 (0.78–1.85) BMI >40 kg·m−2 15 (14%) 0.64 (0.36–1.16) 0.68 (0.38–1.23) Outcomes Death BMI <18.5 kg·m−2 1 (3.4%) 1.22 (0.16–9.61) 0.92 (0.11–7.59) BMI 18.5–24.9 kg·m−2 14 (2.8%) 1 (ref.) 1 (ref.) BMI 25.0–29.9 kg·m−2 22 (3.1%) 1.08 (0.55–2.14) 1.09 (0.55–2.18) BMI 30.0–34.9 kg·m−2 14 (3.4%) 1.20 (0.56–2.54) 1.21 (0.57–2.60) BMI 35.0–39.9 kg·m−2 5 (3.2%) 1.15 (0.41–3.23) 1.29 (0.45–3.71) BMI >40 kg·m−2 1 (1.0%) 0.33 (0.04–2.55) 0.53 (0.07–4.18) Recurrent VTE BMI <18.5 kg·m−2 1 (3.4%) 1.92 (0.24–15.67) 1.90 (0.23–15.57) BMI 18.5–24.9 kg·m−2 9 (1.8%) 1 (ref.) 1 (ref.) BMI 25.0–29.9 kg·m−2 21 (2.9%) 1.62 (0.74–3.57) 1.55 (0.70–3.42) BMI 30.0–34.9 kg·m−2 14 (3.4%) 1.88 (0.81–4.40) 1.82 (0.78–4.25) BMI 35.0–39.9 kg·m−2 2 (1.3%) 0.71 (0.15–3.30) 0.71 (0.15–3.34) BMI >40 kg·m−2 3 (2.9%) 1.59 (0.42–5.99) 1.41 (0.78–2.53) Hospitalisation BMI <18.5 kg·m−2 0 (0%) 0 0 BMI 18.5–24.9 kg·m−2 16 (3.3%) 1 (ref.) 1 (ref.) BMI 25.0–29.9 kg·m−2 34 (4.7%) 1.48 (0.81–2.72) 1.49 (0.81–2.75) BMI 30.0–34.9 kg·m−2 23 (5.6%) 1.75 (0.91–3.37) 1.74 (0.90–3.35) BMI 35.0–39.9 kg·m−2 11 (7.1%) 2.29 (1.04–5.04) 2.39 (1.08–5.32) BMI >40 kg·m−2 5 (4.8%) 1.50 (0.54–4.20) 1.99 (0.70–5.67) Bleeding BMI <18.5 kg·m−2 0 (0%) 0 0 BMI 18.5–24.9 kg·m−2 3 (0.6%) 1 (ref.) 1 (ref.) BMI 25.0–29.9 kg·m−2 7 (1.0%) 1.61 (0.41–6.25) 1.72 (0.44–6.74) BMI 30.0–34.9 kg·m−2 9 (2.2%) 3.63 (0.98–13.50) 3.82 (1.02–14.34) BMI 35.0–39.9 kg·m−2 8 (5.2%) 8.93 (2.34–34.10) 9.99 (2.56–38.92) BMI >40 kg·m−2 3 (2.9%) 4.84 (0.96–24.33) 7.26 (1.37–38.32) All adverse events BMI <18.5 kg·m−2 2 (6.9%) 1.23 (0.279–5.43) 1.08 (0.24–4.90) BMI 18.5–24.9 kg·m−2 28 (5.7%) 1 (ref.) 1 (ref.) BMI 25.0–29.9 kg·m−2 47 (6.6%) 1.16 (0.72–1.89) 1.15 (0.70–1.87) BMI 30.0–34.9 kg·m−2 35 (8.5%) 1.53 (0.92–2.57) 1.50 (0.89–2.52) BMI 35.0–39.9 kg·m−2 12 (7.8%) 1.40 (0.69–2.83) 1.47 (0.71–2.94) BMI >40 kg·m−2 7 (6.7%) 1.20 (0.51–2.82) 1.55 (0.65–3.72) BMI <18.5 kg·m−2, n=29; 18.5–24.9 kg·m−2, n=492; 25.0–29.9 kg·m−2, n=716; 30.0–34.9 kg·m−2, n=413; 35.0–39.9 kg·m−2, n=154; >40 kg·m−2, n=104. Ref.: BMI 18.5–24.9 kg·m−2. Proportion was calculated per BMI category with follow-up up to 12 months. NT-proBNP: N-terminal pro-brain natriuretic peptide; sPESI: simplified Pulmonary Embolism Severity Index; RV/LV: right ventricular/left ventricular ratio; DVT: deep vein thrombosis; VTE: venous thromboembolism. #: for age and sex; sPESI only adjusted for sex.
