The pulmonary embolism risk score system reduces the incidence and mortality of pulmonary embolism after gastric bypass

Background Pulmonary embolism (PE) is a leading cause of death after roux-en-Y gastric bypass (RYGB); therefore, current recommendations for prophylaxis may be inadequate. Methods We reviewed our first 1,341 patients (controls) who underwent RYGB and weighted factors that may have contributed to PE...

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Bibliographic Details
Published in:Surgery 2009-10, Vol.146 (4), p.678-685
Main Authors: Caruana, Joseph A., MD, Anain, Paul M., MD, Pham, Dang Tuan, MD
Format: Article
Language:English
Subjects:
Adult
Female
Gastric Bypass - adverse effects
Heparin - therapeutic use
Humans
Male
Middle Aged
Postoperative Complications - prevention & control
Pulmonary Embolism - epidemiology
Pulmonary Embolism - mortality
Pulmonary Embolism - prevention & control
Retrospective Studies
Surgery
Venous Thromboembolism - prevention & control
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Summary:Background Pulmonary embolism (PE) is a leading cause of death after roux-en-Y gastric bypass (RYGB); therefore, current recommendations for prophylaxis may be inadequate. Methods We reviewed our first 1,341 patients (controls) who underwent RYGB and weighted factors that may have contributed to PE to arrive at a pulmonary embolism risk score (PERS). We postulated that more aggressive prophylaxis in higher risk patients might have reduced the incidence of PE. We tested our hypothesis by basing prophylaxis on the PERS in 1,652 subsequent RYGB patients (study group). Standard risk patients (PERS 4) had postdischarge LDUH and a preoperative vena cava filter. Results The 0.36% incidence of PE (6 patients) in the study group was significantly lower ( P
ISSN:0039-6060
1532-7361
DOI:10.1016/j.surg.2009.07.011