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The Incidence of Venous Thromboembolism in Bariatric Patients Diagnosed with Post-Operative Coronavirus
Andrew P. Sanders MD
1, R. Wesley Vosburg MD
2 1Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
2Department of Surgery, Mount Auburn Hospital, Harvard Medical School, Cambridge, MA, USA
Background: Coronavirus has a well-known association with thrombotic complications. Bariatric patients are at a higher baseline risk of thromboembolism given their elevated BMI. We sought to identify and define the association between venous thromboembolism and post-operative Covid diagnosis in bariatric patients.
Methods: We conducted a retrospective cohort study using the MBSAQIP 2021 database to analyze the incidence of post operative VTE. Cohorts were defined by whether the patient was diagnosed with post-operative corona virus. We created a logistic regression model to determine the adjusted odds of post-operative VTE based off various factors. Additionally, we conducted subset analyses of sleeve gastrectomy and RNY bypass patients, the two most frequent bariatric operations.
Results: Patients diagnosed with post-operative Covid were significantly more likely to experience post-operative VTE (1.1% vs 0.3%, p<.001). In our logistic regression model, we found that the adjusted odds of post-operative VTE for patients with post-operative Covid was 3.32 (95% CI 2.01-5.48, p<.001) (Table 1). For RNY bypass patients, the adjusted odds were even greater at 5.03 (95% CI 2.34-10.85, p<.001).
Conclusion: Bariatric patients diagnosed with post-operative Covid have significantly higher odds of post-operative VTE. This persisted on subset analyses of the two most common procedures and appeared particularly important for RNY bypass. In appropriate patients diagnosed with post-operative Covid, the elevated risk of post-operative VTE may warrant prolonged DVT prophylaxis.
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