Prophylactic anticoagulant use in weight loss surgical patients

Not Applicable

Completed

• Conditions: Morbid Obesity; Gastric banding; Diet and Nutrition - Obesity; Surgery - Other surgery

• Registration Number: ACTRN12619000907145
• Lead Sponsor: Dr Syed Tabish Razi Zaidi

Brief Summary

There is a lack of clear guidance for the prophylactic use of anticoagulants for patients undergoing laparoscopic adjustable gastric banding (LAGB) surgery. This study aimed to evaluate the risk of venous thromboembolism (VTE), prophylactic use of enoxaparin and clinical outcomes in patients undergoing primary and revisional LAGB procedures. A retrospective cohort study evaluated the prophylactic use of enoxaparin in adult patients who underwent primary and revisional (band and port) LAGB procedures. The incidence of VTE and major bleeding was investigated during a 90-day follow-up period. We included 112 and 100 patients who had undergone primary and revisional LAGB surgery, respectively. The majority of patients (97%) had a mild risk of VTE development using a post-discharge VTE risk calculator tool published from the Cleveland Clinic. Overall, 69% patients received standard enoxaparin dose i.e 40 mg once daily. All primary procedure patients received prophylactic enoxaparin, compared to 79% and 20% of revisional patients who underwent band and port procedures, respectively. Use of enoxaparin was more common in patients admitted overnight. The overall VTE incidence after 90 days was 0.9%, and no major bleeding events were observed. Obese patients received standard 40 mg daily dose of enoxaparin. No higher doses was given to obese patients, likely because LAGB is low risk surgical procedure.

Detailed Description

Not available

Study Timeline

• Results First Posted: 1900-01-01
• Study Completion: 2018-12-31
• Study Start: 2019-06-27
• Last Update Posted: 15 July 2019

Recruitment & Eligibility

• Status: Completed
• Sex: All
• Target Recruitment: 212

Inclusion Criteria

A retrospective cohort study was conducted of adult (age greater than or equal to 18 years) obese patients (BMI more than or equal to 30 kg/m2) who underwent primary and revisional bariatric surgery at the Royal Hobart Hospital (RHH) and the Hobart Private Hospital (HPH), from 1 Jan 2013 to 31 Dec 2017

Exclusion Criteria

Patients were excluded from the study if they were on regular anticoagulant or vitamin K therapy, underwent a concurrent surgical procedure (e.g. hysterectomy), or had an established congenital or acquired bleeding disorder, varicose veins, renal impairment with an estimated glomerular filtration rate < 60 mL/min/1.73m2, prior heparin-induced thrombocytopaenia, haemorrhagic stroke within the previous 3 months, other surgery within the previous 3 months, or if relevant information was missing.

Study & Design

• Study Type: Observational
• Study Design: Not specified