Add like
Add dislike
Add to saved papers

The pulmonary embolism risk score system reduces the incidence and mortality of pulmonary embolism after gastric bypass.

Surgery 2009 October
BACKGROUND: Pulmonary embolism (PE) is a leading cause of death after roux-en-Y gastric bypass (RYGB); therefore, current recommendations for prophylaxis may be inadequate.

METHODS: We reviewed our first 1,341 patients (controls) who underwent RYGB and weighted factors that may have contributed to PE to arrive at a pulmonary embolism risk score (PERS). We postulated that more aggressive prophylaxis in higher risk patients might have reduced the incidence of PE. We tested our hypothesis by basing prophylaxis on the PERS in 1,652 subsequent RYGB patients (study group). Standard risk patients (PERS <4) were ambulated 2 hours after surgery, had application of intermittent compression devices, and received subcutaneous low-dose, unfractionated heparin (LDUH). Intermediate risk patients (PERS = 4) received standard prophylaxis and 3 weeks of postdischarge LDUH. High-risk patients (PERS >4) had postdischarge LDUH and a preoperative vena cava filter.

RESULTS: The 0.36% incidence of PE (6 patients) in the study group was significantly lower (P <.05) than the 1% incidence (13 patients) in the controls. Three of 189 men in the control group died of PE, whereas there were no deaths from PE in 271 men in the study group (P <.05).

CONCLUSION: The PERS may be an appropriate scoring system for determining preoperatively the level of risk for postoperative PE in RYGB patients. Basing prophylaxis on the level of risk reduces the incidence and mortality of PE and consumes resources judiciously.

Full text links

We have located links that may give you full text access.
Can't access the paper?
Try logging in through your university/institutional subscription. For a smoother one-click institutional access experience, please use our mobile app.

For the best experience, use the Read mobile app

Mobile app image

Get seemless 1-tap access through your institution/university

For the best experience, use the Read mobile app

All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.

By using this service, you agree to our terms of use and privacy policy.

Your Privacy Choices Toggle icon

You can now claim free CME credits for this literature searchClaim now

Get seemless 1-tap access through your institution/university

For the best experience, use the Read mobile app