Factors Associated with Increased Risk for Pulmonary Embolism After Metabolic and Bariatric Surgery: Analysis of Nearly One Million Patients

Background Metabolic and bariatric surgery (MBS) has a low incidence of post-operative morbidity and mortality. Understanding risk factors associated with complications that occur allows surgeons to define at-risk patients and assess the need for preventive and prophylactic measures. Objectives To determine risk factors associated with development of pulmonary embolism (PE) within 30 days of MBS and to predict the increased risk for mortality when PE occurs. Setting USA, MBSAQIP database. Methods Analysis of the MBSAQIP database was undertaken. This included information on 966,646 MBS cases from 2015 to 2019 in the USA. Results Twenty- two risk factors for development of PE post-MBS were identified to be statistically significant. Conclusions PE is a relatively uncommon complication after MBS. When it does occur, there is a 50.9-fold increased risk for mortality. Patients with significant risk factors for PE may benefit from higher dose perioperative and/or extended VTE prophylaxis after MBS.