{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T08:57:41Z","timestamp":1792400261580,"version":"4.4.0"},"reference-count":29,"publisher":"Springer Science and Business Media LLC","issue":"10","license":[{"start":{"date-parts":[[2025,9,20]],"date-time":"2025-09-20T00:00:00Z","timestamp":1758326400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,9,20]],"date-time":"2025-09-20T00:00:00Z","timestamp":1758326400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["OBES SURG"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>Abstract\n<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>Post-operative bleeding is a known complication after metabolic bariatric surgery (MBS). This study evaluates the national trends in the rates of bleeding, factors associated with bleeding, and impact of bleeding complication on other outcomes.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>MBSAQIP database from 2015 to 2021 was utilized to perform multivariable regression analysis of pre-operative factors associated with bleeding for all MBS, as well as gastric bypass (RYGB) and sleeve gastrectomy (SG) subsets. Propensity matching using pre-operative factors was performed for patients with and without a bleeding complication to compare peri-operative outcomes.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Rates of post-operative bleeding decreased overall from 1.01% in 2015 to 0.69% in 2021. RYGB (OR 2.08, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01) had a higher risk of bleeding compared to SG. Open surgical approach (OR 2.33, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01), therapeutic anticoagulation (OR 2.49, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01), renal insufficiency (OR 1.61, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01), and history of MI (OR 1.26, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01) were highly associated with bleeding. Pre-operative demographics associated with increased bleeding risk included older age (OR 1.16\u20131.31, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01), male gender (OR 1.10, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01) and Asian race (OR 1.47, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01). Staple line reinforcement (OR 0.76, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01) and oversewing (OR 0.79, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01) were protective against bleeding after SG. Bleeding was associated with 18 times higher risk of major complications (42.57% vs 2.33%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01) and 8 times higher risk of death (1.06% vs 0.13%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>The risk of bleeding after MBS has decreased over the past 7\u00a0years. Patients suffering a bleeding complication have a markedly higher risk of major complications and death. Therefore, identifying methods to reduce post-operative bleeding should be a priority.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s11695-025-08231-7","type":"journal-article","created":{"date-parts":[[2025,9,20]],"date-time":"2025-09-20T17:56:59Z","timestamp":1758391019000},"page":"4079-4086","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Evaluating National Trends in Bleeding Associated with Metabolic Bariatric Surgery over 7 Years"],"prefix":"10.1007","volume":"35","author":[{"given":"Tina","family":"Bharani","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Divyansh","family":"Agarwal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdelrahman","family":"Nimeri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Tsai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neil","family":"Ghushe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malcolm","family":"Robinson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Talar","family":"Tatarian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Tavakkoli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Sheu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,9,20]]},"reference":[{"issue":"9","key":"8231_CR1","doi-asserted-by":"publisher","first-page":"879","DOI":"10.1001\/jama.2020.12567","volume":"324","author":"DE Arterburn","year":"2020","unstructured":"Arterburn DE, Telem DA, Kushner RF, et al. 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