Obesity Surgery

, Volume 21, Issue 9, pp 1371–1376

The Long-Term Risk of Venous Thromboembolism Following Bariatric Surgery

  • Kimberley Eden Steele
  • Michael A. Schweitzer
  • Gregory Prokopowicz
  • Andrew D. Shore
  • Lisa C. B. Eaton
  • Anne O. Lidor
  • Martin A. Makary
  • Jeanne Clark
  • Thomas H. Magnuson
Clinical Research

DOI: 10.1007/s11695-011-0445-7

Cite this article as:
Steele, K.E., Schweitzer, M.A., Prokopowicz, G. et al. OBES SURG (2011) 21: 1371. doi:10.1007/s11695-011-0445-7

Abstract

Background

Venous thromboembolism (VTE) is a leading cause of morbidity and mortality following bariatric surgery. The exact duration and magnitude of post-surgery risk for VTE, however, is unclear. We analyzed a large administrative database to determine the long-term risk and predictors for VTE in patients undergoing bariatric surgery.

Methods

A private insurance claims database was used to identify 17,434 patients who underwent bariatric surgery. Longitudinal data were available for each patient for up to 12 months post-surgery. We used logistic regression to identify independent predictors for VTE events.

Results

The incidence of VTE during the index surgical hospitalization was .88%. This cumulative rate rose to 2.17% at 1 month and 2.99% by 6 months post-surgery. Over 74% of VTE events occurred after discharge. Risk factors identified for VTE developing by 6 months post-surgery included male sex (odds ratio (OR) = 1.68; confidence limits (CL) = 1.37–2.07), age ≥ 55 years (OR = 2.18; CL = 1.56–3.03), smoking (OR = 1.86; CL = 1.06–3.27), and previous VTE (OR = 7.48; CL = 5.78–9.67). The laparoscopic adjustable gastric band was less likely to result in VTE compared to open or laparoscopic gastric bypass (OR = .31; CL = .13–.75).

Conclusions

The period of increased risk for VTE following bariatric surgery extends well beyond the initial hospital discharge and 30 days after surgery. The high frequency of VTE up to 6 months following bariatric surgery suggests that more aggressively extended prophylaxis should be considered in patients at higher risk for VTE.

Keywords

Morbid obesity Venous thromboembolism Bariatric surgery Complications 

Copyright information

© Springer Science + Business Media, LLC 2011

Authors and Affiliations

  • Kimberley Eden Steele
    • 1
    • 4
  • Michael A. Schweitzer
    • 1
  • Gregory Prokopowicz
    • 3
  • Andrew D. Shore
    • 2
  • Lisa C. B. Eaton
    • 1
  • Anne O. Lidor
    • 1
  • Martin A. Makary
    • 1
  • Jeanne Clark
    • 3
  • Thomas H. Magnuson
    • 1
  1. 1.Department of SurgeryThe Johns Hopkins University School of MedicineBaltimoreUSA
  2. 2.Department of Health Policy and ManagementJohns Hopkins Bloomberg School of Public HealthBaltimoreUSA
  3. 3.Department of MedicineThe Johns Hopkins University School of MedicineBaltimoreUSA
  4. 4.Department of SurgeryJohns Hopkins Bayview Medical CenterBaltimoreUSA

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