Unfractionated heparin using actual body weight without dose capping in obese pediatric patients—Subgroup analysis from an observational cohort study

2021 ◽  
Author(s):  
Alexis K. Kuhn ◽  
Surbhi Saini ◽  
Joseph Stanek ◽  
Amy Dunn ◽  
Riten Kumar
Keyword(s):  
Body Weight ◽  
Cohort Study ◽  
Actual Body ◽  
Unfractionated Heparin ◽  
Subgroup Analysis ◽  
Pediatric Patients ◽  
Observational Cohort Study ◽  
Actual Body Weight ◽  
Observational Cohort

Unfractionated heparin infusion for treatment of venous thromboembolism based on actual body weight without dose capping

2019 ◽  
Vol 25 (1) ◽  
pp. 47-54 ◽  
Author(s):  
Julia A Shlensky ◽  
Kristina M Thurber ◽  
John G O’Meara ◽  
Narith N Ou ◽  
Jennifer L Osborn ◽  
...  
Keyword(s):  
Body Weight ◽  
Venous Thromboembolism ◽  
Actual Body ◽  
Unfractionated Heparin ◽  
Obese Group ◽  
Morbidly Obese ◽  
Actual Body Weight ◽  
Bleeding Events ◽  
Heparin Infusion ◽  
Significant Difference

Controversy exists regarding the use of dose capping of weight-based unfractionated heparin (UFH) infusions in obese and morbidly obese patients. The primary objective of this study was to compare time to first therapeutic activated partial thromboplastin time (aPTT) in hospitalized patients receiving UFH for acute venous thromboembolism (VTE) among three body mass index (BMI) cohorts: non-obese (< 30 kg/m2), obese (30–39.9 kg/m2), and morbidly obese (⩾ 40 kg/m2). In this single-center, retrospective cohort study, patients were included if they ⩾ 18 years of age, had a documented VTE, and were on an infusion of UFH for at least 24 hours. Weight-based UFH doses were calculated using actual body weight. A total of 423 patients met the inclusion criteria, with 230 (54.4%), 146 (34.5%), and 47 (11.1%) patients in the non-obese, obese, and morbidly obese cohorts, respectively. Median times to therapeutic aPTT were 16.4, 16.6, and 17.1 hours in each cohort. Within 24 hours, the cumulative incidence rates for therapeutic aPTT were 70.7% for the non-obese group, 69.9% for the obese group, and 61.7% for the morbidly obese group (obese vs non-obese: HR = 1.02, 95% CI: 0.82–1.26, p = 0.88; morbidly obese vs non-obese: HR = 0.87, 95% CI: 0.62–1.21, p = 0.41). There was no significant difference in major bleeding events between BMI groups (obese vs non-obese, p = 0.91; morbidly obese vs non-obese, p = 0.98). Based on our study, heparin dosing based on actual body weight without a dose cap is safe and effective.

scholarly journals Prevalence and Prognostic Significance of Frailty in Gerontal Inpatients With Pre-clinical Heart Failure: A Subgroup Analysis of a Prospective Observational Cohort Study in China

2020 ◽  
Vol 7 ◽  
Author(s):  
Pei-Pei Zheng ◽  
Si-Min Yao ◽  
Jing Shi ◽  
Yu-Hao Wan ◽  
Di Guo ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cohort Study ◽  
Subgroup Analysis ◽  
Frailty Index ◽  
Observational Cohort Study ◽  
Prospective Observational Cohort Study ◽  
Frailty Phenotype ◽  
Observational Cohort ◽  
Clinical Heart Failure

Objective: To evaluate the prognostic value of frailty in gerontal pre-clinical heart failure (stage B heart failure, SBHF) inpatients.Background: The association between frailty and SBHF remains unknown.Methods: We conducted a subgroup analysis of a prospective observational cohort study on frailty. The previous study recruited 1,000 elderly inpatients who were consecutively admitted to a tertiary referral hospital in Beijing, China, from September 2018 to February 2019. The outcomes were all-cause death or readmission at 1-year follow-up. SBHF was diagnosed for asymptomatic cardiac structural or functional abnormalities. Frailty was assessed using the Comprehensive Geriatric Assessment-Frailty Index (CGA-FI).Results: Overall, 531 inpatients aged ≥65 years were deemed to have SBHF and followed up for 1 year. Of them, 34.5% exhibited frailty. During the follow-up period, all-cause death or readmission occurred in 157 (29.5%) participants. Of these participants, 36.6% (67/183) and 25.9% (90/348) belonged to the frail and non-frail groups, respectively (χ2 = 6.655, P = 0.010). Frailty, defined by the CGA-FI, rather than Fried frailty phenotype, could independently predict 1-year all-cause death or readmission (hazard ratio, 1.56; 95% confidence interval, 1.03–2.35; P = 0.034) and was more suitable for predicting all-cause death or readmission than N-terminal pro-B-type natriuretic peptide in female SBHF inpatients aged 80 years or over(AUCCGA−FI vs. AUCNT−proBNP 0.654 vs. 0.575, P = 0.017).Conclusions: Frailty is highly prevalent even among SBHF inpatients aged ≥65 years. The CGA-FI can independently predict 1-year all-cause death or readmission, rather than Fried frailty phenotype. Frailty in gerontal SBHF inpatients deserves more attention.Clinical Trial registration: ChiCTR1800017204; date of registration: 07/18/2018.

scholarly journals Addition of sulphonylurea to metformin does not relevantly change body weight: a prospective observational cohort study ( ZODIAC ‐39)

2016 ◽  
Vol 18 (10) ◽  
pp. 973-979 ◽  
Author(s):  
Dennis Schrijnders ◽  
Raiza Wever ◽  
Nanne Kleefstra ◽  
Sebastiaan T. Houweling ◽  
Kornelis J. J. van Hateren ◽  
...  
Keyword(s):  
Body Weight ◽  
Cohort Study ◽  
Observational Cohort Study ◽  
Prospective Observational Cohort Study ◽  
Observational Cohort

Influence of vitamin D on outcomes following burn injury: An observational cohort study

2017 ◽  
Author(s):  
Khaled Al-Tarrah ◽  
Carl Jenkinson ◽  
Martin Hewison ◽  
Naiem Moiemen ◽  
Janet Lord
Keyword(s):  
Vitamin D ◽  
Cohort Study ◽  
Burn Injury ◽  
Observational Cohort Study ◽  
Observational Cohort

The Pros and Cons of Gastric Bypass Surgery in Obese Individuals with Type 2 Diabetes—Nationwide, Matched, Observational Cohort Study

Diabetes ◽  
2018 ◽  
Vol 67 (Supplement 1) ◽  
pp. 131-OR
Author(s):  
VASILEIOS LIAKOPOULOS ◽  
ANN-MARIE SVENSSON ◽  
INGMAR NASLUND ◽  
BJORN ELIASSON
Keyword(s):  
Type 2 Diabetes ◽  
Gastric Bypass ◽  
Cohort Study ◽  
Bypass Surgery ◽  
Gastric Bypass Surgery ◽  
Observational Cohort Study ◽  
Observational Cohort ◽  
Pros And Cons
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