Association Between Surgeon Practice Knowledge and Venous Thromboembolism
ConclusionsGreater discordance between surgeon self-reported and actual perioperative VTE chemoprophylaxis is associated with significantly increased risk of VTE. Further understanding of the system characteristics associated with these practices may yield insights into how best to improve appropriate VTE chemoprophylaxis.
AbstractObesity and diabetes can lead to heart failure with preserved ejection fraction (HFpEF), potentially because they both cause expansion and inflammation of epicardial adipose tissue and thus lead to microvascular dysfunction and fibrosis of the underlying left ventricle. The same process also causes an atrial myopathy, which is clinically evident as atrial fibrillation (AF); thus, AF may be the first manifestation of HFpEF. Many patients with apparently isolated AF have latent HFpEF or subsequently develop HFpEF. Most patients with obesity or diabetes who have AF and exercise intolerance have increased left atrial p...
We describe these rare conditions and the dysregulation of neuropathways in obesity and review successes and failures in treatments in both syndromic and nonsyndromic obesity.Recent FindingsThe best-described form of syndromic obesity is Prader –Willi Syndrome (PWS). While recent pharmacotherapies (specifically beloranib) demonstrated improvements in weight in PWS, the unfortunate adverse effect of deep vein thrombosis and pulmonary embolism necessitated the halting of its further development. Additional treatments are in development whi ch target the signaling of ghrelin and other hypothalamic targets known to be dy...
ConclusionIVCF seems to be beneficial for patients undergoing bariatric surgery.
This study evaluates the incidence of bariatric surgery (BS) before total joint arthroplasty (TJA) in New York State and compares patient comorbidities and 90-day postoperative complications of patients with and without BS before TJA. METHODS: The NY Statewide Planning and Research Cooperative System database between 2005 and 2014 was reviewed and 343,710 patients with TJA were identified. Patients were stratified into the following three cohorts: group 1 (patients who underwent BS
Obesity is a known risk factor for postoperative venous thromboembolism (VTE). Early ambulation after bariatric surgery is an effective and common practice for VTE prophylaxis. While early postoperative ambulation has become a standard of care, rarely is it objectively measured despite readily available pedometers. Objective measurements are needed to study the effects of age, gender, and body mass index(BMI) on postoperative ambulation effort.
The popularity of sleeve gastrectomy seems to have increased the risk of mesenteric venous thrombosis (MVT) and DVT/PE, necessitating identification of a safe, simple regimen for extended prophylaxis. Objectives: Evaluate the incidence of bleeding complications and VTE events among patients receiving apixaban for VTE prophylaxis post-op.
Laparoscopic sleeve gastrectomy (LSG) is today the most performed bariatric procedures in the world, and porto-mesenteric vein thrombosis (PMVT) has been reported as one of the rare complications of LSG. The purpose of our work is to present the prevalence, clinical presentation, and outcomes of PMVT in patients undergoing LSG in our service.
There is an appreciable variability in approaches for thromboprophylaxis among bariatric surgeons. Current ASMBS guidelines recommend mechanical prophylaxis and early ambulation. Additional chemical prophylaxis with low-molecular weight heparin or unfractionated heparin may be prescribed by the bariatric surgeon. The incidence of venous thromboembolism (VTE) 90 days post bariatric surgery is 0.42%. Most post discharge VTE events occur within the first 30 days after discharge. There is no consensus regarding extended anticoagulation prophylaxis for adolescents.
This study aims to assess the safety of bariatric surgery on these patients.MethodsData was extracted from 2015 to 2017 using the MBSAQIP database. Included patients were those who underwent a primary LSG or LRYGB. A multivariable regression analysis was performed looking at 30-day outcomes for pre-operatively anticoagulated patients. A secondary propensity-matched analysis was performed comparing outcomes among patients undergoing LSG vs LRYGB.ResultsA total of 430,396 patients were analyzed, 11,013 (2.56%) of which were taking anticoagulation medications pre-operatively. Absolute 30-day complication rates (8.73% vs 3.36%,p
Authors: Hamadi R, Marlow CF, Nassereddine S, Taher A, Finianos A Abstract Introduction: Rates of obesity have been increasing worldwide and with the current situation obesity now represents an epidemic. Bariatric surgery is one the most effective ways to help reduce weight and sustain weight loss. Venous thromboembolism is a major cause of morbidity and mortality among bariatric surgery patients with no clearly established guidelines on prophylaxis. Areas covered: In this review the authors summarize clinical studies evaluating unfractionated heparin (UFH) and low molecular weight heparins (LMWH) in bariatric surg...