MyNM Patient Portal    I    Careers    I    Pay a Bill    I    Financial Assistance    I    For Physicians    I    Northwestern Medicine Newsroom

Obesity and Bariatric Surgery

Obese patients who are undergoing surgery are at increased risk for developing deep vein thrombosis (DVT) and pulmonary embolism (PE) collectively known as venous thromboembolism (VTE). Pulmonary embolism is a leading cause of death for bariatric patients. Diagnosing DVT is difficult in severely obese patients and often they have subtle first signs which can mean a DVT may not be diagnosed until it has become a fatal PE. The number of bariatric surgeries has been steadily been increasing over the years increasing the number of patients at risk of VTE.

Talk to your doctor about your risk and ways to prevent VTE before bariatric surgery.

Obese Patients at Increased Risk
  • Body Mass Index (BMI) ≥ 50 kg/m2
  • Chronic Leg Edema
  • Inactivity
  • Surgery >2-3 hours

Additional Risk Factors
  • Heart Failure
  • History of VTE, or Family History of VTE
  • History of Pelvic Surgery
  • Venous Stasis Disease
  • Age > 60
  • Oral Contraceptive Use
  • Sleep Apnea
  • Diabetes
  • Clotting Blood Disorders

Prevention
  • Pre- and post-operative Unfractionated Heparin, Low Molecular Weight Heparin, IVC filter placement or continuous IV heparin infusions during surgery.
  • Intermittent Compression Devices
  • Compression Stockings
  • Early Ambulation
Recommendations
  • All patients should receive pre- and post-operative anticoagulation.
  • High risk patients should receive IVC filters or intra-operative heparin infusions followed by 3 months of Coumadin therapy.

References
IVC Filter Clinic | Northwestern Medicine