Incidence of Venous Thromboembolism After Bariatric Surgery: A Population-Based Cohort Study
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The incidence of venous thromboembolism (VTE) after bariatric surgery is uncertain.
Using the resources of the Rochester Epidemiology Project and the Mayo Bariatric Surgery Registry, we identified all residents of Olmsted County, Minnesota, with incident VTE after undergoing bariatric surgery from 1987 through 2005. Using the dates of bariatric surgery and VTE events, we determined the cumulative incidence of VTE after bariatric surgery by using the Kaplan–Meier estimator. Cox proportional hazards modeling was used to assess patient age, sex, weight, and body mass index as potential predictors of VTE after bariatric surgery.
We identified 396 residents who underwent 402 bariatric operations. The most common operation was an open Roux-en-Y gastric bypass (n = 228). Eight patients had VTE that developed within 6 months (7 within 1 month) after surgery; five events occurred after hospital discharge but within 1 month after bariatric surgery. The cumulative incidence of VTE at 7, 30, 90, and 180 days was 0.3, 1.9, 2.1, and 2.1 %, respectively (180-day 95 % confidence interval (CI), 0.7–3.6 %). Patient age was a predictor of postoperative VTE (hazard ratio, 1.89 per 10-year increase in age; 95 % CI, 1.01–3.55; P = 0.05).
In our population-based study, bariatric surgery had a high risk of VTE, especially for older patients. Because most VTE events occurred after hospital discharge, a randomized controlled trial of extended outpatient thromboprophylaxis is warranted in patients undergoing open Roux-en-Y gastric bypass for medically complicated obesity.
KeywordsBariatric surgery Deep vein thrombosis Epidemiology Obesity Pulmonary embolism Venous thromboembolism
Deep vein thrombosis
International Classification of Diseases, Ninth Revision
Rochester Epidemiology Project
Roux-en-Y gastric bypass
Research reported in this publication was supported by grants from the National Heart, Lung and Blood Institute under award number HL66216 to Dr. Heit, and the National Institute on Aging under award number R01AG034676 of the National Institutes of Health, and by the Mayo Foundation. The content is solely the responsibility of the authors and does not represent the official views of the National Institutes of Health.
Conflict of Interest
Dr Heit declares that he has served on Advisory Boards for which he has received honoraria. Dr Sarr declares that he is a consultant for EnteroMedics, Inc; this function is not related to this study. Drs Froehling, Daniels, Mauck, Collazo-Clavell, Ashrani, Bailey, and Ms Petterson declare no conflicts of interest.