Efficacy and Safety of Pharmacoprophylaxis for Venous Thromboembolism in Patients Undergoing Bariatric Surgery: a Systematic Review and Meta-analysis

Zhao, Ying; Ye, Zhikang; Lin, J; Zhang, Zhiqi; Tian, Peirong; Zhang, Zhongtao; Zhang, Peng; Cui, Xiangli

doi:10.1007/s11695-021-05825-9

Cited by 8 publications

(7 citation statements)

References 38 publications

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“…There was a severe risk of bias, imprecision, and inconsistency. The overall conclusion was that standard LMWH dosing may be effective and safe but that the current evidence is insufficient to support extended prophylaxis [ 3 ].…”

Section: Resultsmentioning

confidence: 99%

“…The fatality rate was between 25 and 58%, calculated from the incidence of VTE in the described cases [12]. In contrast, only about 3% of major postoperative bleeding events are known to be fatal, with most patients reporting full or uneventful recovery after hemorrhagic complications [3,11]. (28 days total) 160−200 kg 80 mg/12 hrs for 14 days followed by 80 mg once/day for 14 days 100 mg/12 hrs for 14 days followed by 60 mg/12 hrs for 14 days (28 days total) (28 days total) More than 200 kg 80 mg/12 hrs for 14 days followed by 60 mg/12 hrs for 14 days 100 mg/12 hrs for 14 days followed by 80 mg/12 hrs for 14 days (28 days total) (28 days total) Note to the new regimen if there is an allergy to enoxaparin, we shift to fondaparinux as follows:…”

Section: Postoperative Bleedingmentioning

confidence: 94%

Section: Postoperative Bleedingmentioning

confidence: 99%

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Towards Zero Thromboembolic Events After Bariatric Metabolic Surgery

et al. 2023

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Section: Resultsmentioning

confidence: 99%

Section: Postoperative Bleedingmentioning

confidence: 94%

Section: Postoperative Bleedingmentioning

confidence: 99%

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Towards Zero Thromboembolic Events After Bariatric Metabolic Surgery

et al. 2023

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“…Too little high-quality research, as well as the doubts about the appropriate doses of LMWH in obese patients make it difficult to determine the optimal recommendations. Some studies point to extended outpatient thromboprophylaxis in patients after obesity surgery because most VTE events occur after hospital discharge ( 20 ), however according to the recent meta-analysis, current evidence is insufficient to support this proposal ( 21 ). Recommendations developed by the American Association of Clinical Endocrinologists (AACE), The Obesity Society (TOS), the American Society for Metabolic and Bariatric Surgery (ASMBS), the Obesity Medicine Association (OMA), and the American Society of Anesthesiologists (ASA) suggest thromboprophylaxis (subcutaneously administered unfractionated heparin or low-molecular-weight heparin), given within 24 hours after operation for all patients after bariatric surgery ( 22 ).…”

Section: Discussionmentioning

confidence: 99%

Comparison of pre-and postoperative medication costs in patients who underwent bariatric surgery – a nationwide data analysis

Osińska,

Sanchak,

Śliwczyński

et al. 2024

Front. Public Health

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IntroductionBariatric surgery has known health benefits and may lower the medication-related costs. This study aimed to assess the cost of medications prior to and after bariatric surgery in the Polish nationwide registry.MethodsThe study included 2,390 adults. The analysis was conducted separately for a 12-month pre-operative period, and a 12-month postoperative period. The total costs of medication and cost per anatomical therapeutic chemical group were assessed and the mean cost per patient in the preoperative and postoperative periods was compared.ResultsThe study showed a significant increase in the overall medication costs and mean costs of medications per patient in the year after bariatric surgery. This increase was related mainly to low-molecular-weight heparins used in the 1st month after surgery. Alternatively, costs of medication used in the cardiovascular system diseases and anti-infectives decreased significantly. The total costs of hypoglycemic agents were reduced by 46%, antihypertensive medications by 29%, and lipid-lowering drugs by 38.ConclusionsIn general, medication costs are higher in the first year after surgery. The increase results from the perioperative use of low-molecular-weight heparins, whereas a significant cost reduction of glucose-, lipid-lowering, antihypertensive, and anti-infective medications was observed.

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“…A dosagem padrão de HBPM pode ser eficaz e segura. As evidências atuais são insuficientes para suportar profilaxia prolongada (Zhao et al, 2022).…”

Section: Discussionunclassified

Uso de heparina na prevenção de tromboembolismo venoso em pós-operatório de cirurgia bariátrica

Machado

Andrade²,

Vieira³

2022

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A terapia de prevenção de eventos trombóticos em paciente submetidos à cirurgia bariátrica vem ganhando espaço na literatura científica. Como base nesse tema realizou-se uma revisão integrativa de literatura com o objetivo de analisar a produção científica nacional e internacional referente aos empregos mais eficazes de heparina na prevenção de Tromboembolismo Venoso. O corpus de análise reuniu 13 artigos publicados, entre 2017 e 2022, localizados nas bases de dados MEDLINE, LILACS E IBECS. A maioria dos artigos foi publicada em periódicos internacionais com idioma em inglês. Diversas foram as abordagens metodológicas adotadas, com predomínio de estudos transversais retrospectivos. Foi evidenciado que existem muitos protocolos sobre o uso de HBPM e com doses variadas, no entanto todos trazem o uso desse tipo de heparina como redutor de desenvolvimento de Tromboembolismo Venoso. Ainda faltam estudos prospectivos sobre o tipo de droga, a dosagem correta e a duração ideal. Ainda não há recomendações específicas encontradas em diretrizes sobre tromboprofilaxia para TEV.

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Efficacy and Safety of Pharmacoprophylaxis for Venous Thromboembolism in Patients Undergoing Bariatric Surgery: a Systematic Review and Meta-analysis

Cited by 8 publications

References 38 publications

Towards Zero Thromboembolic Events After Bariatric Metabolic Surgery

Towards Zero Thromboembolic Events After Bariatric Metabolic Surgery

Comparison of pre-and postoperative medication costs in patients who underwent bariatric surgery – a nationwide data analysis

Uso de heparina na prevenção de tromboembolismo venoso em pós-operatório de cirurgia bariátrica

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