Evidence map›Paper›PMID 33025253›Full record

ArticleSurgical endoscopy2021

Use of post-discharge heparin prophylaxis and the risk of venous thromboembolism and bleeding following bariatric surgery.

Erin B Fennern, Farhood Farjah, Judy Y Chen, Francys C Verdial, Sara B Cook, Erika M Wolff, Saurabh Khandelwal

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In one paragraph

Article in Surgical endoscopy, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 2 pooled it
–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

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

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, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Assessing the Efficacy of Extended Postoperative Enoxaparin as Thromboprophylaxis for Patients Undergoing Laparoscopic Sleeve Gastrectomy: a Prospective Analysis.Acta informatica medica : AIM : journal of the Society for Medical Informatics of Bosnia & Herzegovina : casopis Drustva za medicinsku informatiku BiH · 2024
    Article
  5. Racial disparities in reasons for mortality following bariatric surgery.Journal of racial and ethnic health disparities · 2023
    Article
  6. Article
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

7 authors.

Erin B FennernDepartment of Surgery, University of Washington, 1959 NE Pacific Street, Box 356310, Seattle, WA, 98195, USA.ORCID 0000-0002-7501-3354
Farhood FarjahDepartment of Surgery, University of Washington, 1959 NE Pacific Street, Box 356310, Seattle, WA, 98195, USA. ffarjah@uw.edu.
Judy Y ChenDepartment of Surgery, University of Washington, 1959 NE Pacific Street, Box 356310, Seattle, WA, 98195, USA.
Francys C VerdialDepartment of Surgery, University of Washington, 1959 NE Pacific Street, Box 356310, Seattle, WA, 98195, USA.
Sara B CookDepartment of Surgery, University of Washington, 1959 NE Pacific Street, Box 356310, Seattle, WA, 98195, USA.
Erika M WolffDepartment of Surgery, University of Washington, 1959 NE Pacific Street, Box 356310, Seattle, WA, 98195, USA.
Saurabh KhandelwalDepartment of Surgery, University of Washington, 1959 NE Pacific Street, Box 356310, Seattle, WA, 98195, USA.

Funding

Renewal: Gastrointestinal Surgery Outcomes Research FellowshipT32DK070555 · NIDDK · UNIVERSITY OF WASHINGTON · PI FLUM, DAVID R · 2010 to 2024
$3.6M
NIDDK NIH HHS T32 DK070555
6 · The paper itself

Abstract

introductionVenous thromboembolism (VTE) is a significant cause of morbidity and mortality after bariatric surgery. Roughly 80% of VTEs occur post-discharge. The frequency of post-discharge heparin (PDH) prophylaxis use is unknown, and evidence about benefits and risks is limited. We aimed to determine the rate of use of PDH prophylaxis and evaluate its relationship with VTE and bleeding events.

methodsUsing the Truven Health MarketScan® database, we performed a retrospective cohort study (2007-2015) of adult patients who underwent sleeve gastrectomy or gastric bypass. We determined PDH prophylaxis from outpatient pharmacy claims, and post-discharge 90-day VTE and bleeding events from outpatient and inpatient claims. We used propensity score-adjusted regression models to mitigate confounding bias.

resultsAmong 43,493 patients (median age 45 years; 78% women; 77% laparoscopic gastric bypass, 17% laparoscopic sleeve gastrectomy, 6% open gastric bypass), 6% received PDH prophylaxis. Overall, 224 patients (0.52%) experienced VTEs, and 806 patients (1.85%) experienced bleeding. The unadjusted VTE rate did not differ between patients who did and did not receive PDH prophylaxis (0.39% vs. 0.52%, respectively; p = 0.347). The unadjusted bleeding rate was higher for the PDH prophylaxis group (2.74% vs. 1.80%, p < 0.001). In our adjusted analysis, a 23% lower risk of VTE in the PDH prophylaxis group was not statistically significant (odds ratio [OR] 0.77, 95% confidence interval [CI] 0.41 to 1.46), whereas the 47% higher risk of bleeding was statistically significant (OR 1.47, 95% CI 1.14 to 1.88).

conclusionsPDH prophylaxis after bariatric surgery is uncommon. In our analysis, use was not associated with a lower VTE risk but was associated with a higher bleeding risk.

Indexed as

Bariatric SurgeryVenous ThromboembolismAdultAftercareAnticoagulantsFemaleHeparinHumansMaleMiddle AgedPatient DischargeRetrospective StudiesAnticoagulantsHeparinBariatric surgeryBleedingChemoprophylaxisVenous thromboembolism

Identifiers

PMID33025253
PMCPMC8910464

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Registered trials

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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.