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Modifiable risk factors of thromboembolism after surgery for IBD

November's issue of the Diseases of the Colon & Rectum identifies risk factors of venous thromboembolism after surgery for inflammatory bowel disease.

News image

Although it is commonly reported that IBD patients are at increased risk for venous thromboembolic events, little real-world data exist regarding their postoperative incidence and related outcomes in everyday practice.

Dr Jessica Wallaert and colleagues identified the rate of venous thromboembolism, and modifiable risk factors within a large cohort of surgical IBD patients.

The researchers performed a retrospective review of IBD patients who underwent colorectal procedures.

Patients with thromboembolism had longer length of stay
Diseaeses of the Colon & Rectum

Patient data were obtained from the American College of Surgeons National Surgical Quality Improvement Program 2004 to 2010 Participant Use Data Files.

The primary outcomes measured were short-term (30-day) postoperative venous thromboembolism.

The team analyzed clinical variables by univariate and multivariate analyses to identify modifiable risk factors for these events.

The researchers found that 10,431 of operations were for Crohn’s disease or ulcerative colitis, and 242 venous thromboembolic events occurred for a combined rate of 1% in Crohn’s disease, and 3% in ulcerative colitis.

Deep vein thrombosis and pulmonary embolism each occurred at a mean of 11 days postoperatively.

The research team found that a multivariate model found that bleeding disorder, steroid use, anesthesia time, emergency surgery, hematocrit less than 37%, malnutrition, and functional status were potentially modifiable risk factors that remained associated with venous thromboembolism on regression analysis.

Patients with thromboembolism had longer length of stay, more complications, and a higher risk of death.

Dr Wallaert's team concludes, "Inflammatory bowel disease patients are at increased risk for postoperative venous thromboembolism."

"Reducing preoperative anemia, steroid use, malnutrition, and anesthesia time may also reduce venous thromboembolism in this at-risk population."

"Risk-reducing, preventative strategies are needed in this at-risk population."

Dis Colon Rectum 2012: 55(11): 1138–1144
14 November 2012

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