Background

The Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) Bariatric Surgical Risk/Benefit Calculator estimates postoperative complication risk based on preoperative factors, but it does not predict venous thromboembolism (VTE). We aimed to determine; a) if the preoperative variables utilized by this tool are associated with risk of postoperative VTE, and (b) 30-day morbidity in patients with VTE.

Methods

The MBSAQIP database was queried for primary bariatric surgery patients from 2015-2021. To assess the risk for postoperative VTE, all MBSAQIP risk calculator variables were utilized. Univariate and Multivariate adjusted logistic regression analysis was performed to determine which patient factors increased risk of postoperative VTE. All other outcomes and complications were compared using chi-square or Mann-Whitney-U.

Results

Out of 1,346,468 patients, 0.3% developed VTE, conserved during the entire study period. Age, vascular risk, Diabetes Mellitus, dialysis, GERD, history of PE, history of DVT, steroid/immunosuppressant use for chronic condition, previous foregut surgery, and non-band surgery independently increased odds of postoperative VTE (p<0.05). Compared to non-VTE patients, patients who developed postoperative VTE had increased reoperations, reinterventions, unplanned ICU admission, readmissions, morbidity, mortality, and longer hospital stay (p <0.05).

Conclusions

This analysis demonstrates: a) at least 10 preoperative variables from the MBSAQIP Bariatric Surgical Risk/Benefit Calculator are associated with increased risk of postoperative VTE; b) patients who developed postoperative VTE have significantly worse perioperative outcomes after primary bariatric surgery. We suggest the liberal use of extended VTE chemoprophylaxis in patients with identifiable preoperative risk factors and the creation of a VTE-risk calculator.