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Obes Surg. 2008 Jul;18(7):791-6. doi: 10.1007/s11695-007-9382-x. Epub 2008 Apr 3.

Post discharge prophylactic anticoagulation in gastric bypass patient-how safe?

Author information

  • 1Department of Surgery, Hospital of Saint Raphael, New Haven, CT 06511, USA. petfunmiojo@yahoo.co.uk

Abstract

BACKGROUND:

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.

METHODS:

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) > or =50 kg/m(2) with chronic venous stasis and/or obstructive sleep apnea, previous history of PE or deep vein thrombosis (DVT) or BMI > or =60 kg/m(2). 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.

RESULTS:

The groups were similarly matched for age, body mass index, and risk factors. No episode of major bleeding after discharge occurred in either group.

CONCLUSION:

The use of low molecular weight heparin for prophylactic anticoagulation after open gastric bypass is not associated with risk of major bleeding.

PMID:
18386108
[PubMed - indexed for MEDLINE]
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