Evaluation of The Risk of Pulmonary Thromboembolism Using a Padua Score In Laparoscopic Sleeve Gastrectomy: a Retrospective Study
Abstract
Background: Pulmonary thromboembolism in bariatric surgery is a complication that has higher rates of postoperative morbidity and mortality, requiring rapid diagnosis and treatment. As morbid obesity rates increase in society, the development potential of pulmonary thromboemboli further increases. The aim of our study was to evalute clinical, laboratory and radiological outcomes of patients who have been diagnosed with pulmonary tromboembolism and treated retrospectively.Material and methods: The clinical follow up cards were collected of patients who had undergone Laparoscopic sleeve gastrectomy for morbid obesity between March 2014 to January 2016 retrospectively. Clinical, radiological, laboratory, demographic characteristics outcomes and Padua scores were evaluated. Postoperative data and complications of the patients were evaluated statistically. Factors that might affect postoperative pulmonary thromboembolism were evaluated by univariate regression analysis.Results: The gender of patients were 146 55% female and 124 45% male. The mean age was 44.7 ± 4.3 years. Also mean postoperative stay in hospital was 5.7 ± 2.3 days. Patients performed varicose vein socks in mid-high-risk MR and low-risk LR groups while the pneumothic device was applied to very high-risk VHR and high-risk groups. Despite the protective procedures, deep vein thrombosis was seen in 3 patients and pulmonary thromboembolism was seen in 2 patients p
Keywords
References
- 1. Cohen AT, Tapson VF, Bergmann JF, Goldhaber SZ, Kakkar AK, Deslandes B, et al. Venous thromboembolism risk and prophylaxis in the acute hospital care setting (Endorse Study): a multinational cross-sectional study. Lancet 2008;371:387–94. [CrossRef]
- 2. Kearon C. Natural history of venous thromboembolism. Circulation 2003;107:22–30. [CrossRef]
- 3. Roy PM, Meyer G, Vielle B, Le Gall C, Verschuren F, Carpentier F, et al. Appropriateness of diagnostic management and outcomes of suspected pulmonary embolism. Ann Intern Med 2006;144:157–64. [CrossRef]
- 4. Leizorovicz A, Cohen AT, Turpie AG, Olsson CG, Vaitkus PT, Goldhaber SZ. Randomized, placebo-controlled trial of dalteparin for the prevention of venous thromboembolism in acutely ill medical patients. Circulation 2004;110:874–9. [CrossRef]
- 5. Geerts WH, Pineo GF, Heit JA, Bergqvist D, Lassen MR, Colwell CW, Ray JG. Prevention of venous thromboembolism: the seventh ACCP conference on antithrombotic and thrombolytic therapy. Chest 2004;126:338S–408S. [CrossRef]
- 6. Owens WD. American Society of Anesthesiologists Physical Status Classification System is not a risk classification system. Anesthesiology 2001;94:378. [CrossRef]
- 7. Bartlett MA, Mauck KF, Daniels PR. Prevention of venous thromboembolism in patients undergoing bariatric surgery. Vasc Health Risk Manag 2015;11:461–77. [CrossRef]
- 8. Cushman M. Epidemiology and risk factors for venous thrombosis. Semin Hematol 2007;44:62–9. [CrossRef]
- 9. Lee JA, Zierler BK, Glenny RW, Wittkowsky AK, Servellen GV, Amin AN. Venous thromboembolism prevention strategies in hospitalized patients. JCOM - J Clin Outcomes Manage 2011;18:66–73.
- 10. Tapson VF. Thrombolytic therapy for acute pulmonary embolism. Semin Thromb Haemost 2013;39:452–8. [CrossRef]
- 11. Merli GJ. Pathophyiology of venouse thrombosis, thrombophilia, and the diagnosis of deep venouse thrombosis –pulmonary embolism in the elderly. Clin Geriatr Med 2006;22:75–92. [CrossRef]
- 12. Motte S, Samama CM, Guay J, Barré J, Borg JY, Rosencher N. Prevention of postoperative venous thromboembolism. Risk assessment and methods of prophylaxis. Can J Anaesth 2006;53:S68–79. [CrossRef]
- 13. Stein PD, Firth JD. Deep venous thrombosis and pulmonary Embolism. In: Warrell DA, Cox TM, Firth JD, Benz EJ Jr, editors. Oxford Textbook of Medicine, 4th ed. New York: Oxford University Press 2003. pp.1137–49.
- 14. Singh K, Podolsky ER, Um S, Saba S, Saeed I, Aggarwal L, et al. Evaluating the safety and Efficacy of BMI-based preoperative administration of low-molecular-weight heparin in morbidly obese patients undergoing Roux-en-Y gastric bypass surgery. Obez Surg 2012;22:47–51. [CrossRef]
- 15. Guyatt GH, Norris SL, Schulmann S, Hirsh J, Eckman MH, Akl EA, et al. Methodology for the development of antithrombotic therapy and prevention of thrombosis guidelines—antithrombotic therapy and prevention of thrombosis, 9th ed. American College of Chest Physicians Evidence-based Clinical Practice Guidelines. Chest 2012;141:53S–70S. [CrossRef]
- 16. Chan MM, Hamza N, Ammori BJ. Duration of surgery independently influences risk of venous thromboembolism after laparoscopic bariatric surgery. Surg Obes Relat Dis 2013;9:88–93. [CrossRef]
- 17. Sakon M, Maehara Y, Yoshikawa H, Akaza H. Incidence of venous thromboembolism following major abdominal surgery: a multicenter, prospective epidemiological study in Japan. J Thromb Haemost 2006;4:581–6. [CrossRef]
- 18. Andreescu AC, Cushman M, Rosendaal FR. D-dimer as a risk factor for deep vein thrombosis: the Leiden thrombophilia study. J Thromb Haemost 2002;87:47–51. [CrossRef]
- 19. Barbar S, Noventa F, Rossetto V, Ferrari A, Brandolin B, Perlati M, et al. A risk assessment model for the identification of hospitalized medical patients at risk for venous thromboembolism: the Padua Prediction Score. J Thromb Haemost 2010;8:2450–7. [CrossRef]
- 20. Prandoni P, Lensing WAA, Prins MH, Ciammaichella M, Perlati M, Mumoli N, et al. Prevalence of pulmonary embolism among patients hospitalized for syncope. N Engl J Med 2016;375:1524–31. [CrossRef]
- 21. Gonzalez QH, Tishler DS, Plata-Munoz JJ, Bondora A, Vickers SM, Leath T, Clements RH. Incidence of clinically evident deep venous thrombosis after laparoscopic Roux-en-Y gastric bypass. Surg Endosc 2004;18:1082–4. [CrossRef]
- 22. Holländer SW, Sifft A, Hess S, Klingen HJ, Djalali P, Birk D. Identifying the Bariatric Patient at Risk for Pulmonary Embolism: Prospective Clinical Trial Using Duplex Sonography and Blood Screening. Obez Surg 2015;25:2011–7. [CrossRef]
Laparoskopik Sleeve Gastrektomi De Pulmoner Tromboemboli Riskinin Padua Skoru ile Değerlendirilmesi: Retrospektif Bir Çalışma
Abstract
Amaç: Pulmoner tromboemboli bariatrik cerrahide postoperatif dönemde yeterli önlem alınmazsa morbidite ve mortalitenin yüksek olduğu ve bu nedenle hızlı tanı ve tedavi gerektiren bir kompikasyondur. Toplumdaki morbid obezite oranı arttıkça pulmoner tromboemboli’nin gelişme potansiyeli daha da artış göstermektedir. Çalışmamızın amacı pulmoner tromboemboli tanısı konularak tedavi edilen olguların klinik, laboratuvar ve radyolojik sonuçlarınıretrospektif olarak değerlendirmekti.Gereç ve Yöntem: Bariatrik cerrahi kliniğimizde Mart 2014 ile Ocak 2016 tarihleri arasında morbid obezite nedeniyle laparoskopik sleeve gastrektomi geçiren hastaların dosyaları retrospektif olarak incelendi. Olguların klinik, radyolojik, laboratuar, demografik özellikleri ile Padua skorları değerlendirildi. Hastaların postoperatif dönemdeki verileri ve komplikasyonları istatistiksel olarak değerlendirildi. Postoperatif pulmoner tromboemboli riskini etkileyebilecek faktörler tek değişkenli regresyon analizi ile değerlendirildi. Bulgular: Hastaların 146’sı %55 kadın ,124’u %45 erkekti. Ortalama yaş 44.7 ± 4.3 olarak belirlendi. Ayrıca ortalama operasyon sonrası hastanede kalış süresi 5.7 ± 2.3 gündü. Hastalardan çok-yüksek-riskli VHR ve yüksek-riskli HR gruplara postoperatif dönemde pnömotik cihazı uygulanırken, orta-riskli MR ve düşük-riskli LR gruplara varis çorabı uygulandı. Uygulanan koruyucu işlemlere rağmen 3 hastada derin ven trombozu ve 2 hastada pulmoner tromboemboli görüldü p
Keywords
References
- 1. Cohen AT, Tapson VF, Bergmann JF, Goldhaber SZ, Kakkar AK, Deslandes B, et al. Venous thromboembolism risk and prophylaxis in the acute hospital care setting (Endorse Study): a multinational cross-sectional study. Lancet 2008;371:387–94. [CrossRef]
- 2. Kearon C. Natural history of venous thromboembolism. Circulation 2003;107:22–30. [CrossRef]
- 3. Roy PM, Meyer G, Vielle B, Le Gall C, Verschuren F, Carpentier F, et al. Appropriateness of diagnostic management and outcomes of suspected pulmonary embolism. Ann Intern Med 2006;144:157–64. [CrossRef]
- 4. Leizorovicz A, Cohen AT, Turpie AG, Olsson CG, Vaitkus PT, Goldhaber SZ. Randomized, placebo-controlled trial of dalteparin for the prevention of venous thromboembolism in acutely ill medical patients. Circulation 2004;110:874–9. [CrossRef]
- 5. Geerts WH, Pineo GF, Heit JA, Bergqvist D, Lassen MR, Colwell CW, Ray JG. Prevention of venous thromboembolism: the seventh ACCP conference on antithrombotic and thrombolytic therapy. Chest 2004;126:338S–408S. [CrossRef]
- 6. Owens WD. American Society of Anesthesiologists Physical Status Classification System is not a risk classification system. Anesthesiology 2001;94:378. [CrossRef]
- 7. Bartlett MA, Mauck KF, Daniels PR. Prevention of venous thromboembolism in patients undergoing bariatric surgery. Vasc Health Risk Manag 2015;11:461–77. [CrossRef]
- 8. Cushman M. Epidemiology and risk factors for venous thrombosis. Semin Hematol 2007;44:62–9. [CrossRef]
- 9. Lee JA, Zierler BK, Glenny RW, Wittkowsky AK, Servellen GV, Amin AN. Venous thromboembolism prevention strategies in hospitalized patients. JCOM - J Clin Outcomes Manage 2011;18:66–73.
- 10. Tapson VF. Thrombolytic therapy for acute pulmonary embolism. Semin Thromb Haemost 2013;39:452–8. [CrossRef]
- 11. Merli GJ. Pathophyiology of venouse thrombosis, thrombophilia, and the diagnosis of deep venouse thrombosis –pulmonary embolism in the elderly. Clin Geriatr Med 2006;22:75–92. [CrossRef]
- 12. Motte S, Samama CM, Guay J, Barré J, Borg JY, Rosencher N. Prevention of postoperative venous thromboembolism. Risk assessment and methods of prophylaxis. Can J Anaesth 2006;53:S68–79. [CrossRef]
- 13. Stein PD, Firth JD. Deep venous thrombosis and pulmonary Embolism. In: Warrell DA, Cox TM, Firth JD, Benz EJ Jr, editors. Oxford Textbook of Medicine, 4th ed. New York: Oxford University Press 2003. pp.1137–49.
- 14. Singh K, Podolsky ER, Um S, Saba S, Saeed I, Aggarwal L, et al. Evaluating the safety and Efficacy of BMI-based preoperative administration of low-molecular-weight heparin in morbidly obese patients undergoing Roux-en-Y gastric bypass surgery. Obez Surg 2012;22:47–51. [CrossRef]
- 15. Guyatt GH, Norris SL, Schulmann S, Hirsh J, Eckman MH, Akl EA, et al. Methodology for the development of antithrombotic therapy and prevention of thrombosis guidelines—antithrombotic therapy and prevention of thrombosis, 9th ed. American College of Chest Physicians Evidence-based Clinical Practice Guidelines. Chest 2012;141:53S–70S. [CrossRef]
- 16. Chan MM, Hamza N, Ammori BJ. Duration of surgery independently influences risk of venous thromboembolism after laparoscopic bariatric surgery. Surg Obes Relat Dis 2013;9:88–93. [CrossRef]
- 17. Sakon M, Maehara Y, Yoshikawa H, Akaza H. Incidence of venous thromboembolism following major abdominal surgery: a multicenter, prospective epidemiological study in Japan. J Thromb Haemost 2006;4:581–6. [CrossRef]
- 18. Andreescu AC, Cushman M, Rosendaal FR. D-dimer as a risk factor for deep vein thrombosis: the Leiden thrombophilia study. J Thromb Haemost 2002;87:47–51. [CrossRef]
- 19. Barbar S, Noventa F, Rossetto V, Ferrari A, Brandolin B, Perlati M, et al. A risk assessment model for the identification of hospitalized medical patients at risk for venous thromboembolism: the Padua Prediction Score. J Thromb Haemost 2010;8:2450–7. [CrossRef]
- 20. Prandoni P, Lensing WAA, Prins MH, Ciammaichella M, Perlati M, Mumoli N, et al. Prevalence of pulmonary embolism among patients hospitalized for syncope. N Engl J Med 2016;375:1524–31. [CrossRef]
- 21. Gonzalez QH, Tishler DS, Plata-Munoz JJ, Bondora A, Vickers SM, Leath T, Clements RH. Incidence of clinically evident deep venous thrombosis after laparoscopic Roux-en-Y gastric bypass. Surg Endosc 2004;18:1082–4. [CrossRef]
- 22. Holländer SW, Sifft A, Hess S, Klingen HJ, Djalali P, Birk D. Identifying the Bariatric Patient at Risk for Pulmonary Embolism: Prospective Clinical Trial Using Duplex Sonography and Blood Screening. Obez Surg 2015;25:2011–7. [CrossRef]
Details
| Primary Language | Turkish |
|---|---|
| Journal Section | Research Article |
| Authors | |
| Publication Date | March 1, 2019 |
| Published in Issue | Year 2019Issue: 1 |