The Science Journal of the American Association for Respiratory Care

2003 OPEN FORUM Abstracts

PULMONARY EMBOLISM FOLLOWING GASTRIC BYPASS SURGERY AT A MILITARY MEDICAL CENTER: A RETROSPECTIVE REVIEW

Austin E. Delacruz, Jr., RRT-NPS, RPFT, Rafaello Goeting, CRT, Sreekumar Subramanian MD,

Departments of Respiratory Therapy and Surgery, David Grant USAF Medical Center, Travis AFB, California, USA 94535

Purpose: Patients undergoing gastric bypass surgery for morbid obesity are at high risk for pulmonary and thromboembolic complications. Recent refinements in post-operative prophylactics against pulmonary embolism (PE) may be responsible for improving patient outcomes. The objective of the present study was to document the prevalence of PE following gastric bypass surgery at our institution in order to better inform patients of the procedure's risk and benefits.

Methods:
We performed a retrospective chart review of all patients undergoing gastric bypass surgery for morbid obesity at our institution from 1996-1999. Patient demographics, body-mass index (BMI), operative times, and the presence or absence of pulmonary embolism as a complication were recorded in a database, along with pertinent factors.

RESULTS:
33 patients underwent gastric bypass surgery at our institution from 1996-1999. The mean BMI was 46 (Range 35-66). 5 of 33 patients (15%) were evaluated for pulmonary embolism with V/Q scan, CT scan or pulmonary angiogram. 1 patient (3%) had a fatal PE diagnosed at post-mortem examination.

CONCLUSION:
Pulmonary embolism is an uncommon, but potentially lethal complication following gastric bypass surgery. Meticulous attention to posoperative prophylactics has reduced the rate of this complication.

Clinical Implication: Pulmonary embolism remains a source of mortality following gastric bypass surgery in a contemporary series of patients at a military medical center.

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