Predictive Factors for Pulmonary Embolism in Patients Undergoing Metabolic and Bariatric Surgery: Insights from the...

Obesity is a major risk factor for many diseases, including cardiovascular disease and cancer, among others. While metabolic and bariatric surgery (MBS) is an effective treatment, pulmonary embolism (PE) remains a concern due to factors like Virchow's triad exacerbated by excess adipose tissue. This study aims to identify perioperative risk factors for PE in patients undergoing MBS to help reduce its incidence.

This study retrospectively analyzed the MBSAQIP PUF database of the year 2023 to identify risk factors for PE within 30 days of sleeve gastrectomy (SG) or Roux-en-Y gastric bypass (RYGB).

A total of 200865 MBS patients (133,620 SG, 67,245 RYGB) were included in the study; the incidence of 30-day postoperative PE was 0.1% for SG and 0.12% for RYGB. For SG, significant PE risk factors included age, BMI, Black/African American race, history of PE, immunosuppressive therapy, and heart failure. For RYGB, risk factors were age, Black/African American race, history of PE/VTE, dialysis, need for surgical conversion, and mechanical-only VTE prophylaxis.

PE is a rare but potentially fatal post-bariatric surgery complication. The most important risk factor was previous history of thromboembolic events in both cohorts. Individualized risk assessment requires further prospective studies.