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Factors Associated with Increased Risk for Pulmonary Embolism After Metabolic and Bariatric Surgery: Analysis of Nearly One Million Patients

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Abstract

Background

Metabolic and bariatric surgery (MBS) has a low incidence of post-operative morbidity and mortality. Understanding risk factors associated with complications that occur allows surgeons to define at-risk patients and assess the need for preventive and prophylactic measures.

Objectives

To determine risk factors associated with development of pulmonary embolism (PE) within 30 days of MBS and to predict the increased risk for mortality when PE occurs.

Setting

USA, MBSAQIP database.

Methods

Analysis of the MBSAQIP database was undertaken. This included information on 966,646 MBS cases from 2015 to 2019 in the USA.

Results

Twenty-two risk factors for development of PE post-MBS were identified to be statistically significant.

Conclusions

PE is a relatively uncommon complication after MBS. When it does occur, there is a 50.9-fold increased risk for mortality. Patients with significant risk factors for PE may benefit from higher dose perioperative and/or extended VTE prophylaxis after MBS.

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Authors and Affiliations

  1. Department of Surgery Mount Auburn Hospital, Harvard Medical School, 355 Waverley Oaks Rd, Suite 100, Waltham, MA, 02452, USA

    R. Wesley Vosburg & Julie J. Kim

  2. Department of Surgery & St. Mary’s Hospital Department of Surgery, UMass Chan Medical School, Waterbury CT, USA

    Nicholas M. Druar

Authors
  1. R. Wesley Vosburg
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  2. Nicholas M. Druar
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  3. Julie J. Kim
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Correspondence to R. Wesley Vosburg.

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Key Points

• Higher BMI, age, and operative length are each associated with an increased risk for PE within 30 days post-MBS.

• Nineteen other factors were identified with increased risk for PE after MBS. History of PE, history of DVT, and oxygen dependence were the 3 highest ranked individual risk factors.

• Occurrence of PE after MBS increases the 30-day mortality rate by 50.9-fold.

• Consideration should be given to extended and/or higher dose perioperative VTE prophylaxis for patients with significant risk factors for PE due to its increased risk for mortality after surgery.

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Wesley Vosburg, R., Druar, N.M. & Kim, J.J. Factors Associated with Increased Risk for Pulmonary Embolism After Metabolic and Bariatric Surgery: Analysis of Nearly One Million Patients. OBES SURG 32, 2433–2437 (2022). https://doi.org/10.1007/s11695-022-06102-z

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  • DOI: https://doi.org/10.1007/s11695-022-06102-z

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