PL-38: Low surgical volumes in hospitals that meet surgical review corporation (SRC) bariatric surgery center of excellence (BSCOE) minimum standards do not demonstrate an adverse impact on surgical outcomes

Abstract

extremities perioperatively and early ambulation reduce venous thromboembolism (VTE) postoperatively. Anti-coagulation medication is recommended by ASMBS to reduce VTE risk. This study examines 30 day post-op VTE or death among bariatric surgery patients who had sequential compression alone (SEQUEN) or with anticoagulation (ANTICOAG). Methods: LABS participants from 10 centers in the US who underwent their first bariatric surgery between 3/2005 and 10/2007 comprise the study group. We examined 30-day incidence of VTE, defined as DVT or PE, and mortality. Results: Of 3,539 patients, 370 (10%) received sequential compression alone, while the others also received anticoagulation therapy. The two groups were similar in age, race, ethnicity, and BMI. There was a significantly higher percentage of males (30% vs. 20%, p 0.0001) and smokers (7% vs. 3%, p 0.003) in the SEQUEN group. The prevalence of hypertension, diabetes, congestive heart failure, history of VTE , vena cava filter, ischemic heart disease, and pulmonary hypertension at baseline, were not significantly different. The SEQUEN group had longer operative times (207 vs. 169 min, p .0001). The two groups were similar in % of re-hospitalization and re-operation. Open surgery was associated with 1.8% of VTE, and laparoscopic surgery with 0.4%. After adjusting for sex, current smoking, length of operation, and history of VTE, there was not a significant difference between groups in the combined incidence of DVT/PE/mortality (1.0% in ANTICOAG versus 0.4% in SEQUEN, p 0.25). Conclusion: The overall incidence of VTE or death was small (1%). The addition of anticoagulation to the use of sequential compression devices may not lower the rate of VTE following bariatric surgery. Further study of this topic is warranted (sample size). PII: S1550-7289(08)00406-1