ArticleThe journal of trauma and acute care surgery2019
Obesity is associated with postinjury hypercoagulability.
Article in The journal of trauma and acute care surgery, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it, 17 citations in OpenAlex.
- Efficacy and Safety of Tranexamic Acid Use in Bariatric Surgery: An Updated Systematic Review and Meta-Analysis.Obesity surgery · 2026Pooled it
- Obesity supersizes macrophage and neutrophil activation after stroke while lipid droplets play a protective role.Journal of neuroinflammation · 2026Article
- Obesity significantly elevates thromboembolism risk in severe trauma, yet essential resuscitation with TXA and erythrocytes remains safe.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026Article
- Platelet mitochondria dysfunction in diabetes mellitus: mechanisms and therapeutic implications.Frontiers in pharmacology · 2026Review
- The Interplay Between Obesity and Venous Thromboembolism: From Molecular Aspects to Clinical Issue.International journal of molecular sciences · 2025Review
- Obesity influences the biological response to injury: a multi-omics analysis.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2025Article
- Adiposity and Coagulation: Predicting Postinjury Coagulation With Advanced Imaging Analysis.The Journal of surgical research · 2023Article
- The association between body mass index and postpartum hemorrhage after cesarean delivery.Scientific reports · 2023Article
- Thromboelastography in obese horses with insulin dysregulation compared to healthy controls.Journal of veterinary internal medicine · 2022Article
- Thromboelastography-Based Profiling of Coagulation Status in Patients Undergoing Bariatric Surgery: Analysis of 422 Patients.Obesity surgery · 2021Article
- Chinese expert consensus on diagnosis and treatment of trauma-induced hypercoagulopathy.Military Medical Research · 2021Article
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Authors and funding
10 authors at 1 institution in 1 country.
Funding
Abstract
backgroundObesity is linked to hypercoagulability with an increased risk of venous thromboembolic events (VTE) in the uninjured population. Therefore, we hypothesize that obesity (body mass index [BMI] ≥30 kg/m [BMI30]) is associated with a hypercoagulable state postinjury characterized by increased clot strength and resistance to fibrinolysis.
methodsOur prospective Trauma Activation Protocol database includes all trauma activations patients for whom a rapid thrombelastography is obtained within 60 minutes postinjury prior to any transfusions. The data set was then stratified by BMI and subjects with BMI30 were compared with those with BMI less than 30 kg/m). The following thrombelastography measurements were obtained: activated clotting time, clot formation rate (angle), maximum clot strength (MA), and % clot lysis 30 minutes after MA (LY30, %). Fibrinolysis shutdown (SD) was defined as LY30 < 0.6% and hyperfibrinolysis (HF) as LY30 greater than 7.6%. Continuous variables are expressed as median (interquartile range).
resultsOverall, 687 patients were included of whom 161 (23%) had BMI30. The BMI30 group was older, had a lower proportion of males and of blunt trauma, and was less severely injured. After adjustment for confounders, BMI30 was independently associated with lower odds of MA less than 55 mm (odds ratio [OR], 0.28; 95% confidence interval [CI], 0.13-0.60) and of HF (OR, 0.31; 95% CI, 0.10-0.97) and higher odds of SD (OR, 1.82; 95% CI, 1.09-3.05). No independent association was observed with angle less than 65° (OR 0.57 95% CI 0.30-1.05). While VTEs were more frequent among BMI30 patients (5.0 vs. 3.3%), this did not reach significance after confounding adjustment (p = 0.11).
conclusionObesity was protective against diminished clot strength and hyperfibrinolysis, and obesity was associated with an increased risk of fibrinolytic SD in severely injured patients. These findings suggest a relative hypercoagulability. Although no difference in VTEs was noted in this study, these findings may explain the higher rate of VTEs reported in other studies. LEVEL OF EVIDENCE: Prognostic and Epidemiological, level III.
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