ArticleInternational journal of surgery protocols2026
The OAT-RCT study: the obesity anticoagulation thromboprophylaxis randomized controlled trial protocol.
Article in International journal of surgery protocols, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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.
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Authors and funding
6 authors.
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Abstract
Background: Venous thromboembolism (VTE) is a recognized and serious complication following bariatric surgery, with the majority of events occurring after hospital discharge. Low-molecular-weight heparin is the most commonly used thromboprophylactic agent in this population. Both enoxaparin and tinzaparin are widely used, but existing evidence suggests a significant proportion of patients with obesity fails to achieve prophylactic anti-Xa levels with either agent. No adequately powered, prospective, head-to-head randomized trial comparing these agents has been conducted in a bariatric surgery population. Methods/Design: The OAT-RCT is a single-center, prospective, open-label, parallel-group randomized controlled trial at St Vincent's University Hospital, Dublin. Adult patients undergoing laparoscopic sleeve gastrectomy or gastric bypass will be randomly allocated in a 1:1 ratio to receive either weight-based tinzaparin (Arm A) or weight-stratified enoxaparin (Arm B) for 21 days post-operatively. The primary endpoint is the proportion of patients achieving prophylactic anti-Xa levels (0.2-0.4 IU/mL) at 3-5 hours after the third dose, measured on post-operative day 2. Secondary endpoints include 30-day bleeding events, VTE incidence, sub- and supra-prophylactic anti-Xa proportions, correlations between anti-Xa and body habitus, adverse drug reactions, and patient-reported treatment satisfaction using the validated TSQM-9 questionnaire at 6 weeks. A total of 180 participants (90 per arm) are required based on a formal power calculation. Discussion: The OAT-RCT is the first adequately powered head-to-head randomized controlled trial comparing anti-Xa levels of tinzaparin and enoxaparin for VTE prophylaxis in bariatric surgery. The results will provide high-quality class I evidence to inform evidence-based prescribing guidelines for this rapidly growing surgical population.
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