Inferior vena cava filters and postoperative outcomes in patients undergoing bariatric surgery: a meta-analysis

Kaw, Roop; Pasupuleti, Vinay; Wayne Overby, D.; Deshpande, Abhishek; Coleman, Craig I.; Ioannidis, John P.A.; Hernandez, Adrian V.

doi:10.1016/j.soard.2014.04.008

Cited by 47Venous Thromboembolism Diagnosis and ManagementBariatric Surgery and OutcomesCardiac, Anesthesia and Surgical Outcomes

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Inferior vena cava filters and postoperative outcomes in patients undergoing bariatric surgery: a meta-analysis

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Kaw, Roop, Pasupuleti, Vinay, Wayne Overby, D., Deshpande, Abhishek, Coleman, Craig I., Ioannidis, John P.A., Hernandez, Adrian V.·2014·Surgery for Obesity and Related Diseases

DOI 10.1016/j.soard.2014.04.008

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Abstract

Background: Pulmonary embolism(PE)accounts for almost 40% of perioperative deaths after bariatric surgery.Placement of prophylactic inferior vena cava(IVC) filter before bariatric surgery to improve outcomes has shown varied results. We performed a meta-analysis to evaluate post- operative outcomes associated with the preoperative placement of IVC filters in these patients. Methods: A systematic review was conducted by three investigators independently in PubMed, EMBASE, the Web of Science and Scopus until February 28,2013.Our search was restricted to studies in adult patients undergoing bariatric surgery with and without IVC filters. Primary outcomes were postoperative deep vein thrombosis(DVT),pulmonary embolism (PE),and postoperative mortality. Meta-analysis used random effects models to account for heterogeneity,and Sidik- Jonkman method to account for scarcity of outcomes and studies. Associations are shown as Relative Risks(RR) and 95% Confidence Intervals(CI). Results: Seven observational studies were identified (n=102,767), with weighted average inci- dences of DVT(0.9%),PE(1.6%),and mortality(1.0%)for a follow-up ranging from 3 weeks to 3 months. Use of IVC filters was associated with an approximately 3-fold higher risk of DVT and death that was nominally significant for the former outcome, but not the latter (RR2.81,95%CI 1.33-5.97, p=0.007; and RR 3.27,95%CI0.78-13.64, p=0.1, respectively);there was no difference in the risk of PE(RR1.02,95%CI0.31-3.77,p=0.9). Moderate to high heterogeneity of effects was noted across studies. Conclusions: Placement of IVC filter before bariatric surgery Is associated with higher risk of postoperative DVT and mortality. A similar risk of PE inpatients with and without IVC filter placement cannot exclude a benefit, given the potential large imbalance in risk at baseline.Ran- domized trials are needed before IVC placement can be recommended. (SurgObesRelatDis 2015;11:268-269.) r 2015 American Society for Metabolic and Bariatric Surgery.

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In a meta-analysis of six observational studies, inferior vena cava filters were associated with a similar risk of pulmonary embolism (RR 1.02, 95% CI 0.31 to 3.37) in patients undergoing bariatric surgery.
“Meta-analysis of six observational studies suggested higher risk of deep venous thrombosis (OR 2.81, 95% CI 1.33 to 5.97), similar risk of pulmonary embolism (RR 1.02, 95% CI 0.31 to 3.37) and a trend towards higher risk of mortality with inferior vena cava filters (RR 3.27, 95% CI 0.78 to 13.64), albeit with wide interval estimates (Supplementary Table S9) [64].”
From Clinical practice guidelines of the European Association for Endoscopic Surgery (EAES) on bariatric surgery: update 2020 endorsed by IFSO-EC, EASO and ESPCOP (2020) · cites this paper as [64]
In a meta-analysis of six observational studies, inferior vena cava filters showed a trend towards higher risk of mortality (RR 3.27, 95% CI 0.78 to 13.64) in patients undergoing bariatric surgery.
“Meta-analysis of six observational studies suggested higher risk of deep venous thrombosis (OR 2.81, 95% CI 1.33 to 5.97), similar risk of pulmonary embolism (RR 1.02, 95% CI 0.31 to 3.37) and a trend towards higher risk of mortality with inferior vena cava filters (RR 3.27, 95% CI 0.78 to 13.64), albeit with wide interval estimates (Supplementary Table S9) [64].”
From Clinical practice guidelines of the European Association for Endoscopic Surgery (EAES) on bariatric surgery: update 2020 endorsed by IFSO-EC, EASO and ESPCOP (2020) · cites this paper as [64]
In a meta-analysis of six observational studies, inferior vena cava filters were associated with a higher risk of deep venous thrombosis (OR 2.81, 95% CI 1.33 to 5.97) in patients undergoing bariatric surgery.
“Meta-analysis of six observational studies suggested higher risk of deep venous thrombosis (OR 2.81, 95% CI 1.33 to 5.97), similar risk of pulmonary embolism (RR 1.02, 95% CI 0.31 to 3.37) and a trend towards higher risk of mortality with inferior vena cava filters (RR 3.27, 95% CI 0.78 to 13.64), albeit with wide interval estimates (Supplementary Table S9) [64].”
From Clinical practice guidelines of the European Association for Endoscopic Surgery (EAES) on bariatric surgery: update 2020 endorsed by IFSO-EC, EASO and ESPCOP (2020) · cites this paper as [64]

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Authors: Kaw, R., Pasupuleti, V., Wayne Overby, D., Deshpande, A., Coleman, C. I., Ioannidis, J. P. A., & Hernandez, A. V.
Affiliations: Cleveland Clinic (US)
Case Western Reserve University (US)
Hartford Hospital (US)
Stanford Medicine (US)
Corresponding author: Kaw, Roop
ORCID: Kaw, Roop
Pasupuleti, Vinay
Deshpande, Abhishek
Coleman, Craig I.
Ioannidis, John P.A.
Venue: Surgery for Obesity and Related Diseases
Publisher: Elsevier BV
Published: 2014-07
Volume: 10
Issue: 4
Pages: 725-733
ISSN: 1550-7289 (ISSN-L)
DOI: 10.1016/j.soard.2014.04.008
OpenAlex: W2051635650
Cited by: 47
References: 19
Citations by year: 2025: 2 · 2024: 5 · 2023: 2 · 2022: 2 · 2021: 3 · 2020: 9 · 2019: 7 · 2018: 2 · 2017: 5 · 2016: 3 · 2015: 6
FWCI: 3.64
Type: journal article
Language: en
Update notices: erratum (2015-01-01)
Open access: bronze
doi.org
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Surgery for Obesity and Related Diseases (publishedVersion)
PubMed (publishedVersion)
LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas) (submittedVersion, cc-by)
Americanae (AECID Library) (submittedVersion, other-oa)
Topics: Health Sciences › Medicine › Internal Medicine › Venous Thromboembolism Diagnosis and Management
Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac, Anesthesia and Surgical Outcomes
Keywords: inferior vena cava filter, bariatric surgery
MeSH terms: Humans, Obesity, Morbid, Pulmonary Embolism, Vena Cava Filters, Venous Thrombosis, Bariatric Surgery

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Inferior vena cava filters and postoperative outcomes in patients undergoing bariatric surgery: a meta-analysis

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