Venous thromboembolism after bariatric surgery performed by Bariatric Surgery Center of Excellence Participants: analysis of the Bariatric Outcomes Longitudinal Database

Winegar, Deborah A.; Sherif, Bintu; Pate, Virginia; DeMaria, Eric J.

doi:10.1016/j.soard.2010.12.008

Cited by 136 publications

(84 citation statements)

References 14 publications

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“…stockings, early post-operative ambulating and intra-and post-operative use of sequential compression devices (EL B, C, D [193][194][195][196] ). -Early detection and adequate treatment of gastrointestinal (GI) leaks in suspected patients (newly sustained tachycardia > 120 pulses/min for at least 6 h, fever, tachypnoea, newly established signs of hypoxia, increasing pain, elevated C-reactive protein) through upper GI X-ray or CT studies.…”

Section: Follow-upmentioning

confidence: 99%

Interdisciplinary European Guidelines on Metabolic and Bariatric Surgery

et al. 2013

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In 2012, an outstanding expert panel derived from IFSO-EC (International Federation for the Surgery of Obesity -European Chapter) and EASO (European Association for the Study of Obesity), composed by key representatives of both Societies including past and present presidents together with EASO's OMTF (Obesity Management Task Force) chair, agreed to devote the joint Medico-Surgical Workshop of both institutions to the topic of metabolic surgery as a pre-satellite of the 2013 European Congress on Obesity (ECO) to be held in Liverpool given the extraordinarily advancement made specifically in this field during the past years. It was further agreed to revise and update the 2008 Interdisciplinary European Guidelines on Surgery of Severe Obesity produced in cooperation of both Societies by focusing in particular on the evidence gathered in relation to the effects on diabetes during this lustrum and the subsequent changes that have taken place in patient eligibility criteria. The expert panel composition allowed the coverage of key disciplines in the comprehensive management of obesity and obesity-associated diseases, aimed specifically at updating the clinical guidelines to reflect current knowledge, expertise and evidence-based data on metabolic and bariatric surgery.

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Section: Follow-upmentioning

confidence: 99%

Interdisciplinary European Guidelines on Metabolic and Bariatric Surgery

et al. 2013

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“…BOLD is registered with the National Institutes of Health (NCT01002352; available from http://www.clinicaltrials.gov). 7 Our study population consisted of patients who received GB and AB operations. These two groups were further subcategorized by surgical approach, either open or laparoscopic.…”

Section: Methodsmentioning

confidence: 99%

“…A description of the patient data entered into BOLD and available for this study has been previously reported by the SRC. 7,16,17 Statistical analysis. Statistical analysis was performed using the R Project for statistical computing (http://www.…”

Section: Methodsmentioning

confidence: 99%

“…3,6 Bariatric patients are generally considered to be a group at high risk for postoperative VTE. 7,8 Obesity is a well recognized independent risk factor for VTE, particularly when these patients are hospitalized for surgical procedures. 7,9 Additionally, bariatric patients often have other risk factors that can increase the incidence of postoperative VTE, a complication which has been reported in up to 4% of patients undergoing bariatric surgery despite adequate prophylaxis.…”

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confidence: 99%

“…7,8 Obesity is a well recognized independent risk factor for VTE, particularly when these patients are hospitalized for surgical procedures. 7,9 Additionally, bariatric patients often have other risk factors that can increase the incidence of postoperative VTE, a complication which has been reported in up to 4% of patients undergoing bariatric surgery despite adequate prophylaxis. 8,10,11 Although VTE prophylaxis is routinely used, the optimal means of VTE prophylaxis is not well established and the benefit of prophylactic placement of inferior vena cava filter (PPOIVCF) remains unclear.…”

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confidence: 99%

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Concurrent prophylactic placement of inferior vena cava filter in gastric bypass and adjustable banding operations in the Bariatric Outcomes Longitudinal Database

Li¹,

Górecki²,

Semaan³

et al. 2012

Journal of Vascular Surgery

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Introduction: Postoperative pulmonary embolism (PE) is a leading cause of morbidity and mortality after bariatric surgery. However, the concurrent prophylactic placement of an inferior vena cava filter (CPIVCF) in patients undergoing bariatric operations remains controversial. This study used the Bariatric Outcomes Longitudinal Database (BOLD) to establish associated characters and determine outcomes of CPIVCF for patients undergoing Roux-en-Y gastric bypass (GB) and adjustable gastric banding (AB) surgeries. Methods: We analyzed BOLD, a database of bariatric surgery patient information. GB and AB operations were categorized into open and laparoscopic approaches. Univariate logistic regressions were used to compare between non-CPIVCF and concurrent CPIVCF groups. Significant variables (P < .05) were subsequently input into multivariate regression models: CPIVCF was retained in each model. Results: A total of 322 CPIVCFs (0.33%) were identified from 97,218 GB and AB operations performed between 2007 and 2010 in this retrospective registry study. Significant differences were identified in male gender (21.1% vs 31.4%; P < .001), preoperative body mass index (BMI; 44.5 ؎ 6.6 vs 45.3 ؎ 7; P < .001), and African-American race (10.5% vs 18%; P < .001) between non-CPIVCF and CPIVCF groups. The CPIVCF group had more patients with previous nonbariatric surgery (50% vs 43.6%; P ‫؍‬ .02), a history of venous thromboembolism (VTE; 21.4% vs 3.1%; P < .001), impairment of functional status (7.8% vs 3.1%; P < .001), lower extremity edema (47.2% vs 27.1%; P < .001), obesity hypoventilation syndrome (7.1% vs 2.1%; P < .001), obstructive sleep apnea syndrome (58.1% vs 43.3%; P < .001), and pulmonary hypertension (13% vs 4.1%; P < .001). Patients in the CPIVCF group were more likely to receive GB than gastric banding (77% vs 58.1%; P < .001) and an open surgical approach (21.4% vs 4.8%; P < .001). Operative duration was longer in the CPIVCF group (119 ؎ 67 vs 89 ؎ 52 minutes; P < .001). The CPIVCF group also had a longer length of hospital stay (3 ؎ 2 vs 2 ؎ 6 days; P ‫؍‬ .048), was associated with higher incidence of deep venous thrombosis (DVT; 0.93% vs 0.12%; P < .001), and had a higher mortality (0.31% vs 0.03%; P ‫؍‬ .003) from PE and indeterminate causes. In multivariate analysis, male gender, African-American race, previous nonbariatric surgery, a high BMI, obesity hypoventilation syndrome, history of VTE, lower extremity edema, and pulmonary hypertension were preoperative factors associated with CPIVCF. Conclusions: CPIVCF was associated with specific clinical features, increased health care resource utilization, and a higher mortality in patients undergoing bariatric operations. Although selected patient characteristics influence surgeons to perform CPIVCF, this study was unable to establish an outcome benefit for CPIVCF. ( J Vasc Surg 2012;55:1690-5.)

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Efficacy and Safety of Rivaroxaban for Postoperative Thromboprophylaxis in Patients After Bariatric Surgery

Kröll,

Nett,

Rommers

et al. 2023

JAMA Netw Open

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ImportanceVenous thromboembolism (VTE) is a leading cause of morbidity and mortality after bariatric surgery. Clinical end point studies on thromboprophylaxis with direct oral anticoagulants in patients undergoing bariatric surgery are lacking.ObjectiveTo assess the efficacy and safety of a prophylactic dose of 10 mg/d of rivaroxaban for both 7 and 28 days after bariatric surgery.Design, Setting, and ParticipantsThis assessor-blinded, phase 2, multicenter randomized clinical trial was conducted from July 1, 2018, through June 30, 2021, with participants from 3 academic and nonacademic hospitals in Switzerland.InterventionPatients were randomized 1 day after bariatric surgery to 10 mg of oral rivaroxaban for either 7 days (short prophylaxis) or 28 days (long prophylaxis).Main Outcomes and MeasuresThe primary efficacy outcome was the composite of deep vein thrombosis (symptomatic or asymptomatic) and pulmonary embolism within 28 days after bariatric surgery. Main safety outcomes included major bleeding, clinically relevant nonmajor bleeding, and mortality.ResultsOf 300 patients, 272 (mean [SD] age, 40.0 [12.1] years; 216 women [80.3%]; mean body mass index, 42.2) were randomized; 134 received a 7-day and 135 a 28-day VTE prophylaxis course with rivaroxaban. Only 1 thromboembolic event (0.4%) occurred (asymptomatic thrombosis in a patient undergoing sleeve gastrectomy with extended prophylaxis). Major or clinically relevant nonmajor bleeding events were observed in 5 patients (1.9%): 2 in the short prophylaxis group and 3 in the long prophylaxis group. Clinically nonsignificant bleeding events were observed in 10 patients (3.7%): 3 in the short prophylaxis arm and 7 in the long prophylaxis arm.Conclusions and RelevanceIn this randomized clinical trial, once-daily VTE prophylaxis with 10 mg of rivaroxaban was effective and safe in the early postoperative phase after bariatric surgery in both the short and long prophylaxis groups.Trial RegistrationClinicalTrials.gov Identifier: NCT03522259

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Venous thromboembolism after bariatric surgery performed by Bariatric Surgery Center of Excellence Participants: analysis of the Bariatric Outcomes Longitudinal Database

Cited by 136 publications

References 14 publications

Interdisciplinary European Guidelines on Metabolic and Bariatric Surgery

Interdisciplinary European Guidelines on Metabolic and Bariatric Surgery

Concurrent prophylactic placement of inferior vena cava filter in gastric bypass and adjustable banding operations in the Bariatric Outcomes Longitudinal Database

Efficacy and Safety of Rivaroxaban for Postoperative Thromboprophylaxis in Patients After Bariatric Surgery

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