Evidence map›Paper›PMID 31617101›Full record

ArticleSurgical endoscopy2020

Preoperative anticoagulation in patients undergoing bariatric surgery is associated with worse outcomes.

Maria S Altieri, Jie Yang, Chencan Zhu, L Konstantinos Spaniolas, Mark A Talamini, Aurora D Pryor

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Article in Surgical endoscopy, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Maria S AltieriBrody School of Medicine, East Carolina University, 600 Moye Boulevard, Greenville, NC, 27834, USA. Altieri.m@gmail.com.
Jie YangDepartment of Family, Population and Preventive Medicine, Stony Brook University Medical Center, Stony Brook, USA.
Chencan ZhuDepartment of Applied Mathematics and Statistics, Stony Brook University, Stony Brook, USA.
L Konstantinos SpaniolasDivision of Bariatric, Foregut and Advanced Gastrointestinal Surgery, Department of Surgery, Stony Brook University Medical Center, Stony Brook, USA.
Mark A TalaminiDivision of Bariatric, Foregut and Advanced Gastrointestinal Surgery, Department of Surgery, Stony Brook University Medical Center, Stony Brook, USA.
Aurora D PryorDivision of Bariatric, Foregut and Advanced Gastrointestinal Surgery, Department of Surgery, Stony Brook University Medical Center, Stony Brook, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionManagement of patients on chronic anticoagulation (AC) in bariatric surgery may present a challenge, as there is a delicate balance between risks of bleeding and thrombotic events, such as deep vein thrombosis (DVT) and pulmonary embolism (PE). The purpose of this study was to evaluate and compare rates of bleeding, thrombotic events, and outcomes of patients on preoperative AC during bariatric surgery.

methodsThe MBSAQIP data sets for 2015 and 2016 was used to identify all patients undergoing adjustable gastric banding (AGB), sleeve gastrectomy (SG), and Roux-en-Y gastric bypass (RYGB). Clinical outcomes included length of stay, 30-day readmission, 30-day reoperations and interventions, perioperative and 30-day death events, need for transfusion, PE, and DVT. Following univariate analysis, multivariable logistic regression models and generalized linear regression model for a negative binomial distributed count outcomes were used after adjusting for surgery type and other factors related to each outcome.

resultsThere were 269,243 records extracted, as there were 6541 (2.43%) patients on preoperative AC. Rates of transfusion, DVT, and PE were 0.67%, 0.18%, and 0.11%. Following multivariable logistic regression, patients with preoperative AC had higher risks of bleeding and DVT (OR 2.7, 95% CI 2.3-3.3, p-value < 0.0001 and OR 2.8, 95% CI 1.9-4, p-value < 0.0001, respectively). In addition, patients with pre-op AC had a higher risk of 30-day readmission (OR 2.1, 95% CI 1.9-2.3, p < 0.0001)/reoperation (OR 1.5, 95% CI 1.2-1.7, p < 0.0001)/reintervention (OR 2.1, 95% CI 1.8-2.4, p < 0.0001), mortality (OR 2.9, 95% CI 2.04-4.069, p < 0.0001), and longer LOS (ratio 1.2, 95% CI 1.199-1.241, p < 0.0001).

conclusionPatients with preoperative AC had worse postoperative outcomes. Bariatric surgeons should be aware of the increased morbidity and mortality, and care must be taken to improve outcomes through close attention to postoperative AC protocols in this group of patients.

Indexed as

Preoperative CareAdultAnticoagulantsBariatric SurgeryBlood Loss, SurgicalFemaleHumansLogistic ModelsMaleMiddle AgedObesity, MorbidPatient ReadmissionPostoperative ComplicationsPostoperative HemorrhagePulmonary EmbolismReoperationAnticoagulantsBariatric surgeryOutcomesPreoperative anticoagulation

Identifiers

PMID31617101

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.