Do sleeve gastrectomy and Roux-en-Y gastric bypass have different venous thromboembolism risk factors? Creation of 30-day Bariatric Hypercoagulation Score.
Bariatric Hypercoagulation Score
Bariatric surgery
Hypercoagulation
Venous thromboembolism
Journal
Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery
ISSN: 1878-7533
Titre abrégé: Surg Obes Relat Dis
Pays: United States
ID NLM: 101233161
Informations de publication
Date de publication:
Nov 2023
Nov 2023
Historique:
received:
14
03
2023
revised:
06
05
2023
accepted:
27
05
2023
pubmed:
20
7
2023
medline:
20
7
2023
entrez:
19
7
2023
Statut:
ppublish
Résumé
Venous thromboembolism (VTE) is a major cause of morbidity and mortality after bariatric surgery, most often occurring after discharge within 30 days after surgery. To determine the risk factors associated with VTE after either sleeve gastrectomy (SG) or Roux-en-Y gastric bypass (RYGB) and to develop a Bariatric Hypercoagulation Score (BHS) to predict 30-day adverse postoperative outcomes. University hospital. Using 2015-2018 data from the Metabolic and Bariatric Surgery Quality Improvement Program, a BHS was created by performing a logistic regression of "venous thromboembolism." The variables with the highest odds ratio (OR) were selected for the SG and RYGB groups. Then, the 30-day outcomes of low-risk (0-1), average-risk (2-3), and high-risk (≥4) BHS were compared. Similar risk factors for VTE were found in both the SG and RYGB groups; the highest OR was shown by history of deep vein thrombosis (SG: 3.54, RYGB: 3.05). Other related factors in both groups were history of pulmonary embolism, prolonged length of stay, Black race, and male sex. Conversely, unique risk factors such as dialysis (OR 1.81) was found in the SG group; meanwhile, prolonged operative time (OR 1.50) and age >60 years (OR 1.28) were for the RYGB group. When comparing the 30-day outcomes, BHS ≥4 had a significantly higher rate of complications (P < .001). SG and RYGB have some risk factors in common for VTE; however, dialysis was associated only with SG, and prolonged operative time and age >60 years were associated only with RYGB. BHS ≥4 showed higher 30-day adverse outcomes. The VTE-correlated variables require special consideration when assessing patients undergoing SG and RYGB.
Sections du résumé
BACKGROUND
BACKGROUND
Venous thromboembolism (VTE) is a major cause of morbidity and mortality after bariatric surgery, most often occurring after discharge within 30 days after surgery.
OBJECTIVES
OBJECTIVE
To determine the risk factors associated with VTE after either sleeve gastrectomy (SG) or Roux-en-Y gastric bypass (RYGB) and to develop a Bariatric Hypercoagulation Score (BHS) to predict 30-day adverse postoperative outcomes.
SETTING
METHODS
University hospital.
METHODS
METHODS
Using 2015-2018 data from the Metabolic and Bariatric Surgery Quality Improvement Program, a BHS was created by performing a logistic regression of "venous thromboembolism." The variables with the highest odds ratio (OR) were selected for the SG and RYGB groups. Then, the 30-day outcomes of low-risk (0-1), average-risk (2-3), and high-risk (≥4) BHS were compared.
RESULTS
RESULTS
Similar risk factors for VTE were found in both the SG and RYGB groups; the highest OR was shown by history of deep vein thrombosis (SG: 3.54, RYGB: 3.05). Other related factors in both groups were history of pulmonary embolism, prolonged length of stay, Black race, and male sex. Conversely, unique risk factors such as dialysis (OR 1.81) was found in the SG group; meanwhile, prolonged operative time (OR 1.50) and age >60 years (OR 1.28) were for the RYGB group. When comparing the 30-day outcomes, BHS ≥4 had a significantly higher rate of complications (P < .001).
CONCLUSIONS
CONCLUSIONS
SG and RYGB have some risk factors in common for VTE; however, dialysis was associated only with SG, and prolonged operative time and age >60 years were associated only with RYGB. BHS ≥4 showed higher 30-day adverse outcomes. The VTE-correlated variables require special consideration when assessing patients undergoing SG and RYGB.
Identifiants
pubmed: 37468337
pii: S1550-7289(23)00565-8
doi: 10.1016/j.soard.2023.05.026
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1246-1252Informations de copyright
Copyright © 2023 American Society for Metabolic and Bariatric Surgery. Published by Elsevier Inc. All rights reserved.