{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T07:57:40Z","timestamp":1790495860020,"version":"4.1.0"},"reference-count":20,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T00:00:00Z","timestamp":1790035200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The American Surgeon\u2122"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Venous thromboembolism (VTE) is a major cause of morbidity and mortality after bariatric surgery, yet the optimal post-discharge prophylaxis agent, dose, and duration remain undefined. Direct oral anticoagulants are a potential alternative to low-molecular-weight heparin, but bariatric-specific data are limited. This study evaluates the successful implementation of a standardized 30-day oral thromboprophylaxis protocol with high completion rates and low observed rates of symptomatic VTE and major bleeding.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective review of patients undergoing bariatric surgery (laparoscopic\/robotic sleeve gastrectomy, gastric bypass, band-to-bypass and sleeve-to-bypass conversion) at a single institution from May 2021 to December 2024. Patients received perioperative unfractionated heparin followed by apixaban 2.5\u00a0mg twice daily for 30\u00a0days post-discharge if hemoglobin was stable on postoperative day one. Revisional surgery (anastomosis revision) and preexisting anticoagulant or antiplatelet therapy were exclusion criteria. The primary outcome was 30-day VTE incidence; the secondary outcome was bleeding requiring surgical or endovascular intervention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 764 patients, 669 completed the full 30-day apixaban course and were analyzed. No VTE events occurred (0%). One patient (0.15%) had a bleeding complication requiring reoperation for an intramural hematoma causing small bowel obstruction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>A standardized institutional protocol utilizing apixaban 2.5\u00a0mg twice daily for 30\u00a0days following bariatric surgery can be implemented with high adherence and low complication rates. Further prospective, multi-institutional studies are warranted to validate these findings and refine patient selection.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00031348261492214","type":"journal-article","created":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T05:48:35Z","timestamp":1790142515000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["From Injections to Implementation: Standardizing Extended Oral Thromboprophylaxis After Bariatric Surgery"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-9370-8332","authenticated-orcid":false,"given":"Robert","family":"Monfort","sequence":"first","affiliation":[{"name":"Atrium Health Navicent Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Trisha","family":"Weber","sequence":"additional","affiliation":[{"name":"Atrium Health Navicent Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oluwaseun","family":"Olusanya","sequence":"additional","affiliation":[{"name":"Atrium Health Navicent Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madison","family":"Boyd","sequence":"additional","affiliation":[{"name":"Atrium Health Navicent Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reagan","family":"Kelly","sequence":"additional","affiliation":[{"name":"Atrium Health Navicent Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bolaji","family":"Olusanya","sequence":"additional","affiliation":[{"name":"Atrium Health Navicent Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kylie","family":"Tobey","sequence":"additional","affiliation":[{"name":"Atrium Health Navicent Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Parel","sequence":"additional","affiliation":[{"name":"Atrium Health Navicent Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danny","family":"Vaughn","sequence":"additional","affiliation":[{"name":"Atrium Health Navicent Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,9,22]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.soard.2010.12.008"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2015.09.005"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0901836"},{"key":"e_1_3_3_5_2","first-page":"461","article-title":"Prevention of venous thromboembolism in patients undergoing bariatric surgery","volume":"11","author":"Bartlett MA","year":"2015","unstructured":"Bartlett MA, Mauck KF, Daniels PR. Prevention of venous thromboembolism in patients undergoing bariatric surgery. Vasc Health Risk Manag. 2015;11:461-477.","journal-title":"Vasc Health Risk Manag"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.soard.2018.01.008"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.soard.2013.03.006"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11695-024-07100-z"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11695-025-07721-y"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e3181ae6dbe"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1097\/MBC.0000000000000369"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0000000000003168"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11695-013-1073-1"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11695-012-0854-2"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.soard.2025.05.004"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11695-025-08036-8"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11695-022-06051-7"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD013683.pub2"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11695-024-07184-7"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.thromres.2017.11.006"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1111\/bcp.13243"}],"container-title":["The American Surgeon\u2122"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00031348261492214","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/00031348261492214","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00031348261492214","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T07:19:04Z","timestamp":1790493544000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/00031348261492214"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,22]]},"references-count":20,"alternative-id":["10.1177\/00031348261492214"],"URL":"https:\/\/doi.org\/10.1177\/00031348261492214","relation":{},"ISSN":["0003-1348","1555-9823"],"issn-type":[{"value":"0003-1348","type":"print"},{"value":"1555-9823","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,22]]},"article-number":"00031348261492214"}}