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01-08-2020 | Sleeve Gastrectomy

Venous thromboembolism risk for the contemporary bariatric surgeon

Authors: Sahil Gambhir, Colette S. Inaba, Reza F. Alizadeh, Jeffry Nahmias, Marcelo Hinojosa, Brian R. Smith, Ninh T. Nguyen, Shaun Daly

Published in: Surgical Endoscopy | Issue 8/2020

Abstract

Background

Postoperative venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE), are the leading causes of morbidity and mortality after bariatric surgery. Although several studies have examined VTE, few have examined risk factors separately for DVT and PE after contemporary bariatric surgery, including laparoscopic sleeve gastrectomy (LSG). Our objective was to define risk factors for DVT and PE independently for both LSG and laparoscopic Roux-en-Y gastric bypass (LRYGB) patients using the largest validated bariatric surgery database.

Methods

The metabolic and bariatric surgery accreditation and quality improvement program (MBSAQIP) database was queried to identify patients who underwent LSG or LRYGB between January 2015 and December 2017. Perioperative data were compared using bivariate analysis. Risk of DVT and PE after LSG or LRYGB was determined using multivariable logistic regression analysis.

Results

During the study period, 369,032 bariatric cases (72% LSG, 28% LRYGB) were performed. The incidence of DVT was similar between LSG and LRYGB (0.2% vs. 0.2%, p = 0.96), while the incidence of PE was decreased for LSG compared to LRYGB (0.1% vs. 0.2%, p < 0.001). Operative length was associated with increased risk of postoperative DVT (OR 1.1, CI 1.01–1.30, p = 0.04) and postoperative PE (OR 1.4, CI 1.16–1.64, p < 0.001) after surgery. The largest independent risk factors for DVT were history of DVT (OR 6.2, CI 4.44–8.45, p < 0.001) and transfusion (OR 4.2, CI 2.48–6.63, p < 0.001). The largest independent risk factors for PE were transfusion (OR 5.0, CI 2.69–8.36, p < 0.001) and history of DVT (OR 2.8, CI 1.67–4.58, p < 0.001). LSG was associated with a decreased risk of PE compared to LRYGB (OR 0.7 CI 0.55–0.91, p = 0.01).

Conclusions

Prolonged operative length is associated with a higher risk of DVT and PE after either LSG or LRYGB. Transfusion and history of DVT are the largest risk factors for developing DVT and PE. There is a decreased risk of PE after LSG compared to LRYGB.

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Title: Venous thromboembolism risk for the contemporary bariatric surgeon
Authors: Sahil Gambhir
Colette S. Inaba
Reza F. Alizadeh
Jeffry Nahmias
Marcelo Hinojosa
Brian R. Smith
Ninh T. Nguyen
Shaun Daly
Publication date: 01-08-2020
Publisher: Springer US
Keywords: Sleeve Gastrectomy
Bariatric Surgery
Bariatric Surgery
Phlebothrombosis
Published in: Surgical Endoscopy / Issue 8/2020
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-019-07134-w

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Venous thromboembolism risk for the contemporary bariatric surgeon

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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