Prescribing patterns of thromboprophylaxis post-bariatric surgeries: no additional benefits of extended prophylaxis
Abstract Background Venous thromboembolism is one of the critical complications of bariatric surgeries resulting in life-threatening outcomes. The benefits and duration of appropriate thromboprophylaxis in the morbidly obese patients stay unclear. The study aims to compare the benefits of in-hospita...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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SpringerOpen
2023-03-01
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| Series: | Future Journal of Pharmaceutical Sciences |
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| Online Access: | https://doi.org/10.1186/s43094-023-00468-2 |
| _version_ | 1797865359346237440 |
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| author | Abdullah S. Almalki Heba Adel Al Recheq Eshtyage Bajnaid Sherif Boraii Doaa H. Abdelaziz Seif El Hadidi |
| author_facet | Abdullah S. Almalki Heba Adel Al Recheq Eshtyage Bajnaid Sherif Boraii Doaa H. Abdelaziz Seif El Hadidi |
| author_sort | Abdullah S. Almalki |
| collection | DOAJ |
| description | Abstract Background Venous thromboembolism is one of the critical complications of bariatric surgeries resulting in life-threatening outcomes. The benefits and duration of appropriate thromboprophylaxis in the morbidly obese patients stay unclear. The study aims to compare the benefits of in-hospital thromboprophylaxis versus extended thromboprophylaxis post-bariatric surgery among a cohort with a high prevalence of morbid obesity. Results A retrospective observational cohort study was conducted on 229 morbidly obese patients who had undergone bariatric surgery in a tertiary care teaching hospital in Saudi Arabia. Upon discharge, the patients were split either to receive no thromboprophylaxis or enoxaparin 40 mg once or twice daily for 14–21 days post-discharge. Primary outcomes were the clinical difference between the study groups in the percentage of patients who developed a symptomatic venous thromboembolic event during postoperative hospitalization or after discharge. Among patients who received no thromboprophylaxis (n = 119), no one developed a venous thromboembolic event, while, in the extended prophylaxis group (n = 110), 1.82% developed a non-fatal one (P = 0.23). Additionally, no significant difference in percentages of bleeding events occurred in both groups (p = 0.054). Conclusions The incidence of venous thromboembolism and bleeding events that occurred with extended thromboprophylaxis were deemed comparable and non-significant to the conventional in-hospital thromboprophylaxis. However, portal thrombosis stays an enigmatic complication despite its documented sparsity in literature. |
| first_indexed | 2024-04-09T23:07:53Z |
| format | Article |
| id | doaj.art-d10af6e10da6408a83a25874692d7e33 |
| institution | Directory Open Access Journal |
| issn | 2314-7253 |
| language | English |
| last_indexed | 2024-04-09T23:07:53Z |
| publishDate | 2023-03-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Future Journal of Pharmaceutical Sciences |
| spelling | doaj.art-d10af6e10da6408a83a25874692d7e332023-03-22T10:38:21ZengSpringerOpenFuture Journal of Pharmaceutical Sciences2314-72532023-03-01911710.1186/s43094-023-00468-2Prescribing patterns of thromboprophylaxis post-bariatric surgeries: no additional benefits of extended prophylaxisAbdullah S. Almalki0Heba Adel Al Recheq1Eshtyage Bajnaid2Sherif Boraii3Doaa H. Abdelaziz4Seif El Hadidi5Department of Pharmaceutical Care Services, King Abdulaziz Medical City, Ministry of National Guard-Health AffairsKing Abdullah Medical City, Pharmaceutical care services administrationKing Abdullah Medical City, Pharmaceutical care services administrationDepartment of Hepatobiliary Pancreatic Surgery, The National Hepatology and Tropical Medicine Research InstituteDepartment of Clinical Pharmacy, The National Hepatology and Tropical Medicine Research InstitutePharmacy Practice and Clinical Pharmacy Department, Faculty of Pharmacy, Future University in EgyptAbstract Background Venous thromboembolism is one of the critical complications of bariatric surgeries resulting in life-threatening outcomes. The benefits and duration of appropriate thromboprophylaxis in the morbidly obese patients stay unclear. The study aims to compare the benefits of in-hospital thromboprophylaxis versus extended thromboprophylaxis post-bariatric surgery among a cohort with a high prevalence of morbid obesity. Results A retrospective observational cohort study was conducted on 229 morbidly obese patients who had undergone bariatric surgery in a tertiary care teaching hospital in Saudi Arabia. Upon discharge, the patients were split either to receive no thromboprophylaxis or enoxaparin 40 mg once or twice daily for 14–21 days post-discharge. Primary outcomes were the clinical difference between the study groups in the percentage of patients who developed a symptomatic venous thromboembolic event during postoperative hospitalization or after discharge. Among patients who received no thromboprophylaxis (n = 119), no one developed a venous thromboembolic event, while, in the extended prophylaxis group (n = 110), 1.82% developed a non-fatal one (P = 0.23). Additionally, no significant difference in percentages of bleeding events occurred in both groups (p = 0.054). Conclusions The incidence of venous thromboembolism and bleeding events that occurred with extended thromboprophylaxis were deemed comparable and non-significant to the conventional in-hospital thromboprophylaxis. However, portal thrombosis stays an enigmatic complication despite its documented sparsity in literature.https://doi.org/10.1186/s43094-023-00468-2Morbid obesityBariatric surgeryThromboprophylaxisExtended therapyAdverse effects |
| spellingShingle | Abdullah S. Almalki Heba Adel Al Recheq Eshtyage Bajnaid Sherif Boraii Doaa H. Abdelaziz Seif El Hadidi Prescribing patterns of thromboprophylaxis post-bariatric surgeries: no additional benefits of extended prophylaxis Future Journal of Pharmaceutical Sciences Morbid obesity Bariatric surgery Thromboprophylaxis Extended therapy Adverse effects |
| title | Prescribing patterns of thromboprophylaxis post-bariatric surgeries: no additional benefits of extended prophylaxis |
| title_full | Prescribing patterns of thromboprophylaxis post-bariatric surgeries: no additional benefits of extended prophylaxis |
| title_fullStr | Prescribing patterns of thromboprophylaxis post-bariatric surgeries: no additional benefits of extended prophylaxis |
| title_full_unstemmed | Prescribing patterns of thromboprophylaxis post-bariatric surgeries: no additional benefits of extended prophylaxis |
| title_short | Prescribing patterns of thromboprophylaxis post-bariatric surgeries: no additional benefits of extended prophylaxis |
| title_sort | prescribing patterns of thromboprophylaxis post bariatric surgeries no additional benefits of extended prophylaxis |
| topic | Morbid obesity Bariatric surgery Thromboprophylaxis Extended therapy Adverse effects |
| url | https://doi.org/10.1186/s43094-023-00468-2 |
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