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

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 1,34.1 patients (conlrols) who underwent RYGB and weighted factors that ma have contributed to PE to arrive fit a pulmonary embolism risk score Vile 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, unfiactionated haprun (LDUH) Intermediate risk patients (PERS = 4) received standard prophylaxis and 3 week of postdischarge LDUH. High-risk patiens (PERS > 4) had poastdischarge LDUH and a preoperative vena cava filter. Results. The 0 36% inculence of PE, (6 Patients) in the Study group was sigrnificantly lower (P < .05) than the 1% incidence (13 patients) in the controls. Three of 189 men in the conlrol group died (of PF, Whereas then, were no deaths from PE in 271 men in the study group (P <. 05) Conclusion. The PERS may be an appropriate scoring system for determing peoperatively 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 (Surgery 2009.-1-10:678-85.)