The Long-Term Risk of Venous Thromboembolism Following Bariatric Surgery
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Kimberley Eden Steele & Michael A. Schweitzer & Gregory Prokopowicz & Andrew D. Shore & Lisa C. B. Eaton & Anne O. Lidor & Martin A. Makary & Jeanne
- چاپ و سال / کشور: 2011
Description
Background Venous thromboembolism (VTE) is a leading cause of morbidity and mortality following bariatric surgery. The exact duration and magnitude of post-surgery risk for VTE, however, is unclear. We analyzed a large administrative database to determine the long-term risk and predictors for VTE in patients undergoing bariatric surgery. Methods A private insurance claims database was used to identify 17,434 patients who underwent bariatric surgery. Longitudinal data were available for each patient for up to 12 months post-surgery. We used logistic regression to identify independent predictors for VTE events. Results The incidence of VTE during the index surgical hospitalization was .88%. This cumulative rate rose to 2.17% at 1 month and 2.99% by 6 months post-surgery. Over 74% of VTE events occurred after discharge. Risk factors identified for VTE developing by 6 months postsurgery included male sex (odds ratio (OR)=1.68; confidence limits (CL)=1.37–2.07), age≥55 years (OR=2.18; CL=1.56–3.03), smoking (OR=1.86; CL=1.06–3.27), and previous VTE (OR=7.48; CL=5.78–9.67). The laparoscopic adjustable gastric band was less likely to result in VTE compared to open or laparoscopic gastric bypass (OR=.31; CL=.13–.75). Conclusions The period of increased risk for VTE following bariatric surgery extends well beyond the initial hospital discharge and 30 days after surgery. The high frequency of VTE up to 6 months following bariatric surgery suggests that more aggressively extended prophylaxis should be considered in patients at higher risk for VTE.
OBES SURG DOI 10.1007/s11695-011-0445-7
