Post discharge prophylactic anticoagulation in gastric bypass patient-how safe?
| Autor: | Peter Ojo, Randolph Reinhold, Elmer Valin, Bolanle Asiyanbola |
|---|---|
| Rok vydání: | 2007 |
| Předmět: |
Adult
Male medicine.medical_specialty Blood transfusion medicine.drug_class Endocrinology Diabetes and Metabolism Deep vein medicine.medical_treatment Gastric Bypass Low molecular weight heparin Hematocrit Postoperative Hemorrhage Drug Administration Schedule Venous stasis Body Mass Index Cohort Studies Young Adult Risk Factors medicine Humans Enoxaparin Retrospective Studies Nutrition and Dietetics medicine.diagnostic_test Dose-Response Relationship Drug business.industry Incidence Anticoagulants Retrospective cohort study Middle Aged medicine.disease Thrombosis Patient Discharge Surgery Pulmonary embolism Obesity Morbid medicine.anatomical_structure Anesthesia Female business Pulmonary Embolism |
| Zdroj: | Obesity surgery. 18(7) |
| ISSN: | 0960-8923 |
| Popis: | It is becoming an increasingly common practice to discharge gastric bypass (GBP) patients on prophylactic anticoagulation. This is because pulmonary embolism (PE) is a common cause of mortality postoperatively. This study was undertaken to: (1) determine the incidence of major bleeding in GBP patients discharged on prophylactic low molecular weight heparin (LMWH)—enoxaparin and, (2) correlate the bleeding risk to the dose used. Retrospective chart review of all open GBP operation from June 2004 to August 2005. One hundred and twenty seven patients were sent home on LMWH for 2 weeks. Indications: Body mass index (BMI) ≥50 kg/m2 with chronic venous stasis and/or obstructive sleep apnea, previous history of PE or deep vein thrombosis (DVT) or BMI ≥60 kg/m2. The study group was divided into two subgroups: 40 mg twice daily (bid) and 60 mg bid LMWH. Statistical analysis was done with the chi-square. The primary outcome measure was major bleeding; defined as bleeding during the period of LMWH use associated with symptomatic decrease in hematocrit (HCT), necessitating stopping LMWH administration before the end of the study period (2 weeks), bleeding-related readmission, blood transfusion, or intervention. Excluded were patients on warfarin or treated with therapeutic LMWH. The groups were similarly matched for age, body mass index, and risk factors. No episode of major bleeding after discharge occurred in either group. The use of low molecular weight heparin for prophylactic anticoagulation after open gastric bypass is not associated with risk of major bleeding. |
| Databáze: | OpenAIRE |
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