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- Title
Bariatric Surgery and the Long-Term Risk of Venous Thromboembolism: A Population-Based Cohort Study.
- Authors
Harrington, Laura B.; Benz, Luke; Haneuse, Sebastien; Johnson, Eric; Coleman, Karen J.; Courcoulas, Anita P.; Li, Robert A.; Theis, Mary Kay; Cooper, Julie; Chin, Philip L.; Grinberg, Gary G.; Daigle, Christopher R.; Chang, Julietta H.; Um, Scott S.; Yenumula, Panduranga R.; Getty, Jorge Zelada; Arterburn, David E.
- Abstract
Purpose: Bariatric surgery is associated with a greater venous thromboembolism (VTE) risk in the weeks following surgery, but the long-term risk of VTE is incompletely characterized. We evaluated bariatric surgery in relation to long-term VTE risk. Materials and Methods: This population-based retrospective matched cohort study within three United States–based integrated health care systems included adults with body mass index (BMI) ≥ 35 kg/m2 who underwent bariatric surgery between January 2005 and September 2015 (n = 30,171), matched to nonsurgical patients on site, age, sex, BMI, diabetes, insulin use, race/ethnicity, comorbidity score, and health care utilization (n = 218,961). Follow-up for incident VTE ended September 2015 (median 9.3, max 10.7 years). Results: Our population included 30,171 bariatric surgery patients and 218,961 controls; we identified 4068 VTE events. At 30 days post-index date, bariatric surgery was associated with a fivefold greater VTE risk (HRadj = 5.01; 95% CI = 4.14, 6.05) and a nearly fourfold greater PE risk (HRadj = 3.93; 95% CI = 2.87, 5.38) than no bariatric surgery. At 1 year post-index date, bariatric surgery was associated with a 48% lower VTE risk and a 70% lower PE risk (HRadj = 0.52; 95% CI = 0.41, 0.66 and HRadj = 0.30; 95% CI = 0.21, 0.44, respectively). At 5 years post-index date, lower VTE risks persisted, with bariatric surgery associated with a 41% lower VTE risk and a 55% lower PE risk (HRadj = 0.59; 95% CI = 0.48, 0.73 and HRadj = 0.45; 95% CI = 0.32, 0.64, respectively). Conclusion: Although in the short-term bariatric surgery is associated with a greater VTE risk, in the long-term, it is associated with a substantially lower risk.
- Subjects
UNITED States; BARIATRIC surgery; THROMBOEMBOLISM; GASTRIC bypass; INTEGRATED health care delivery; MEDICAL care use; COHORT analysis
- Publication
Obesity Surgery, 2024, Vol 34, Issue 6, p2017
- ISSN
0960-8923
- Publication type
Article
- DOI
10.1007/s11695-024-07236-y