Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.
Department of Surgery, Mount Auburn Hospital, Harvard Medical School, Cambridge, Massachusetts.
Surg Obes Relat Dis. 2024 Aug;20(8):730-736. doi: 10.1016/j.soard.2024.01.021. Epub 2024 Feb 8.
Patients who undergo metabolic and bariatric surgery (MBS) are at risk for thromboembolism. Patients are susceptible to coronavirus throughout the perioperative period, which also has a well-known association with thrombotic complications.
To identify and define the association between venous thromboembolism (VTE) and postoperative coronavirus diagnosis in bariatric surgery patients.
United States.
We conducted a retrospective cohort study using the MBS Accreditation and Quality Improvement Program (MBSAQIP) 2021 database to analyze the incidence of VTE within 30 days of surgery. VTE was a composite variable defined as either postoperative pulmonary embolism or postoperative venous thrombus requiring treatment. Cohorts were stratified by whether the patient was diagnosed with postoperative coronavirus. We created a multivariable logistic regression model to determine the adjusted odds of postoperative VTE based on various factors. Additionally, we conducted subset analyses of sleeve gastrectomy and Roux-en-Y bypass cases, the 2 most frequent bariatric operations in the United States.
Patients diagnosed with postoperative coronavirus were significantly more likely to develop postoperative VTE (1.1% versus .3%, P < .001). In our logistic regression model, the adjusted odds of postoperative VTE for patients with postoperative coronavirus was 3.55 (95% CI: 2.15-5.87, P < .001). For patients who underwent Roux-en-Y bypass, the adjusted odds was even greater at 5.69 (95% CI: 2.76-11.70, P < .001).
Early postoperative coronavirus infection after MBS is associated with higher odds of postoperative VTE. This persisted on subset analyses of the 2 most common procedures and appeared particularly important for Roux-en-Y bypass. COVID infection after MBS may warrant prolonged VTE prophylaxis.
接受代谢和减重手术(MBS)的患者存在血栓栓塞风险。患者在围手术期内易感染冠状病毒,而冠状病毒也与血栓并发症密切相关。
确定并定义减重手术患者中静脉血栓栓塞症(VTE)与术后冠状病毒诊断之间的关联。
美国。
我们使用 MBS 认证和质量改进计划(MBSAQIP)2021 数据库进行了一项回顾性队列研究,分析了术后 30 天内 VTE 的发生率。VTE 是一个复合变量,定义为术后肺栓塞或需要治疗的术后静脉血栓。根据患者是否被诊断为术后冠状病毒,对队列进行分层。我们创建了一个多变量逻辑回归模型,以根据各种因素确定术后 VTE 的调整后 odds。此外,我们还对美国最常见的两种减重手术袖状胃切除术和 Roux-en-Y 旁路手术进行了亚组分析。
被诊断为术后冠状病毒的患者发生术后 VTE 的可能性明显更高(1.1%比.3%,P <.001)。在我们的逻辑回归模型中,术后冠状病毒患者发生术后 VTE 的调整后 odds 为 3.55(95%CI:2.15-5.87,P <.001)。对于接受 Roux-en-Y 旁路手术的患者,调整后的 odds 甚至更高,为 5.69(95%CI:2.76-11.70,P <.001)。
MBS 后早期术后冠状病毒感染与术后 VTE 的 odds 增加相关。在两种最常见手术的亚组分析中仍然存在这种情况,对于 Roux-en-Y 旁路手术尤其重要。MBS 后 COVID 感染可能需要延长 VTE 预防。