Perioperative complications increase the risk of venous thromboembolism following bariatric surgery

Am J Surg. 2017 Dec;214(6):1135-1140. doi: 10.1016/j.amjsurg.2017.07.034. Epub 2017 Sep 20.

Abstract

Background: Morbidly obese patients are at increased risk of venous thromboembolism (VTE) following surgery. This study explores the impact of a perioperative complication on the risk of VTE after bariatric surgery.

Methods: Patients who underwent bariatric surgery were identified from the American College of Surgeons National Surgical Quality Improvement Program dataset (2012-2014). The 17 most common perioperative complications were analyzed by multivariate regression analysis to determine the effect of complications on the risk of VTE.

Results: The postoperative incidence of VTE was 0.5% (n = 59,424 bariatric surgeries). The average time to diagnosis of VTE was 11.6 days. 80% of VTE events occurred after discharge. A major complication occurred prior to VTE in 22.6% of patients. The more complications experienced by an individual patient, the more likely they were to experience VTE. Unadjusted thirty-day mortality increased 13.89-fold following VTE (p < 0.0001).

Conclusions: Postoperative complications significantly increase the risk of VTE following bariatric surgery.

Keywords: Bariatric surgery; Complications; NSQIP; Pulmonary embolism; Venous thromboembolism.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Bariatric Surgery*
  • Female
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Obesity, Morbid / surgery*
  • Postoperative Complications / epidemiology*
  • Risk Factors
  • United States / epidemiology
  • Venous Thromboembolism / epidemiology*