Pulmonary embolism and deep venous thrombosis following bariatric surgery. 2013

Paul D Stein, and Fadi Matta
Department of Osteopathic Medical Specialties, Michigan State University College of Osteopathic Medicine, East Lansing, MI, USA. steinp@trinity-health.org

BACKGROUND The contribution of obesity to the thromboembolic risks of surgery suggests that patients undergoing bariatric surgery would have a particularly high risk of postoperative pulmonary embolism (PE) and/or deep venous thrombosis (DVT). This study aimed to assess the prevalence of in-hospital PE, DVT, and venous thromboembolism (VTE) following bariatric surgery in the USA from 2007 to 2009. METHODS We used the database of the Nationwide Inpatient Sample. RESULTS The prevalence of PE was 4,500 of 508,230 (0.9 %). The prevalence of DVT not accompanied by PE was 6,480 of 508,230 (1.3 %) and VTE (either PE or DVT) occurred in 10,980 of 508,230 (2.2 %). In-hospital death among patients with PE was 130 of 508,231 (0.03 %). Vena cava filters were inserted in 1,515 of 508,230 (0.3 %) patients who underwent bariatric surgery. Among patients who had VTE, filters were inserted in 1,150 of 10,980 (10.5 %). Among patients who had neither PE nor DVT, prophylactic vena cava filters were inserted in 365 of 497,250 (0.07 %). Among patients with PE, in-hospital mortality was 25 of 635 (3.9 %) with a filter compared with 105 of 3,865 (2.7 %) (NS) without a filter. However, among patients with DVT alone, in-hospital mortality was 0 of 510 (0 %) with a filter compared with 80 of 5,970 (1.3 %) (P = 0.009) without a filter. CONCLUSIONS This investigation establishes a baseline for the incidence of venous thromboembolic complications following bariatric surgery in recent years. Determination of the present in-hospital rate of PE and DVT may contribute to antithrombotic prophylactic considerations.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009767 Obesity, Morbid The condition of weighing two, three, or more times the ideal weight, so called because it is associated with many serious and life-threatening disorders. In the BODY MASS INDEX, morbid obesity is defined as having a BMI greater than 40.0 kg/m2. Morbid Obesity,Obesity, Severe,Morbid Obesities,Obesities, Morbid,Obesities, Severe,Severe Obesities,Severe Obesity
D011655 Pulmonary Embolism Blocking of the PULMONARY ARTERY or one of its branches by an EMBOLUS. Pulmonary Thromboembolism,Thromboembolism, Pulmonary,Embolism, Pulmonary,Embolisms, Pulmonary,Pulmonary Embolisms,Pulmonary Thromboembolisms,Thromboembolisms, Pulmonary
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D000925 Anticoagulants Agents that prevent BLOOD CLOTTING. Anticoagulant Agent,Anticoagulant Drug,Anticoagulant,Anticoagulant Agents,Anticoagulant Drugs,Anticoagulation Agents,Indirect Thrombin Inhibitors,Agent, Anticoagulant,Agents, Anticoagulant,Agents, Anticoagulation,Drug, Anticoagulant,Drugs, Anticoagulant,Inhibitors, Indirect Thrombin,Thrombin Inhibitors, Indirect
D012307 Risk Factors An aspect of personal behavior or lifestyle, environmental exposure, inborn or inherited characteristic, which, based on epidemiological evidence, is known to be associated with a health-related condition considered important to prevent. Health Correlates,Risk Factor Scores,Risk Scores,Social Risk Factors,Population at Risk,Populations at Risk,Correlates, Health,Factor, Risk,Factor, Social Risk,Factors, Social Risk,Risk Factor,Risk Factor Score,Risk Factor, Social,Risk Factors, Social,Risk Score,Score, Risk,Score, Risk Factor,Social Risk Factor
D013997 Time Factors Elements of limited time intervals, contributing to particular results or situations. Time Series,Factor, Time,Time Factor

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