围手术期并发症会增加肥胖症手术后发生静脉血栓栓塞的风险。
Perioperative complications increase the risk of venous thromboembolism following bariatric surgery.
作者信息
Helm Melissa C, Simon Kathleen, Higgins Rana, Kindel Tammy L, Gould Jon C
机构信息
Medical College of Wisconsin, Department of Surgery, Division of General Surgery, Milwaukee, WI, USA.
Medical College of Wisconsin, Department of Surgery, Division of General Surgery, Milwaukee, WI, USA.
出版信息
Am J Surg. 2017 Dec;214(6):1135-1140. doi: 10.1016/j.amjsurg.2017.07.034. Epub 2017 Sep 20.
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.
背景
病态肥胖患者术后发生静脉血栓栓塞症（VTE）的风险增加。本研究探讨围手术期并发症对减重手术后VTE风险的影响。
方法
从美国外科医师学会国家外科质量改进计划数据集（2012 - 2014年）中识别接受减重手术的患者。通过多因素回归分析对17种最常见的围手术期并发症进行分析，以确定并发症对VTE风险的影响。
结果
VTE的术后发生率为0.5%（n = 59424例减重手术）。VTE的平均诊断时间为11.6天。80%的VTE事件发生在出院后。22.6%的患者在发生VTE之前出现了严重并发症。个体患者经历的并发症越多，发生VTE的可能性就越大。VTE发生后，未调整的30天死亡率增加了13.89倍（p < 0.0001）。
结论
术后并发症显著增加了减重手术后VTE的风险。
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