Background

Venous thromboembolism (VTE) is a major cause of morbidity and mortality after bariatric surgery, most occurring after discharge within 30 postoperative days. We aim to determine the main factors related to VTE for SG and RYGB.

Methods

Using the MBSAQIP 2015-2018, a Bariatric Hypercoagulation Score (BHS) was created by performing a multivariate logistic regression of “Venous Thromboembolism”. The variables with the highest Odds Ratio (OR) were selected for the Sleeve Gastrectomy (SG) and Roux-en-Y Gastric Bypass (RYGB) groups. Then, the 30-day outcomes of low-risk (0-1), average-risk (2-3), and high-risk (>4) BHS were compared.

Results

The BHS for SG and RYGB present similar risk factors for VTE such as a history of DVT (SG; 3.54, RYGB: 3.05), history of PE (SG: 1.61, RYGB: 2.82), prolonged length stay (SG: 2.62, RYGB: 2.73), African American race (SG: 1.72, RYGB: 1.70), and male sex (SG: 1.25, RYGB:1.32). Conversely, dialysis (OR 1.81) was found to be a risk factor in the SG group, meanwhile, prolonged operative time (OR 1.50), and age > 60 years old (OR 1.28) were for the RYGB group. To validate the BHS, the receiver operating curve (ROC) was performed, obtaining an area under the curve (AUC) of 0.62 and 0.68 for SG and RYGB, respectively. In the comparison of the 30-day outcomes, a significantly higher rate of complications was found in the high-risk BHS.

Conclusions

Patients with high-risk BHS had worse postoperative outcomes. The VTE-correlated variables require special consideration when asses patients that will undergo SG and RYGB.