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 27 May 2016

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News

Extended postoperative venous thromboembolism prophylaxis in IBD

This month's issue of the Diseases of the Colon & Rectum investigates the importance of extended postoperative venous thromboembolism prophylaxis in IBD.

News image

The National Comprehensive Cancer Network recommends that patients who have colorectal cancer receive up to 4 weeks of postoperative out-of-hospital venous thromboembolism prophylaxis.

Patients with IBD are at high risk for venous thromboembolism, but there are no recommendations for routine postdischarge prophylaxis.

Dr Molly Gross and colleagues compared the postoperative venous thromboembolism rate in IBD patients versus patients who have colorectal cancer to determine if IBD patients warrant postdischarge thromboembolism prophylaxis.

The researchers performed a retrospective review of IBD patients and patients who had colorectal cancer who underwent major abdominal and pelvic surgery.

Data were collected from the American College of Surgeons National Surgical Quality Improvement Program (2005–2010).

The odds ratio for venous thromboembolism was 1.26 for the IBD patients
Diseases of the Colon & Rectum

The team's primary outcome was 30-day postoperative venous thromboembolism in IBD patients and patients who had colorectal cancer.

Risk factors for venous thromboembolism were analyzed with the use of univariate testing and stepwise logistic regression.

The research team identified a total of 45,964 patients with IBD (8888) and colorectal cancer.

The team noted that 30-day postoperative rate of venous thromboembolism in IBD patients was significantly higher than in patients who had colorectal cancer.

In a model with 15 significant covariates, the odds ratio for venous thromboembolism was 1.26 for the IBD patients in comparison with the patients who have colorectal cancer.

Dr Gross and team commented, "Patients with IBD had a significantly increased risk for postoperative venous thromboembolism in comparison with patients who had colorectal cancer."

"Therefore, postdischarge venous thromboembolism prophylaxis recommendations for IBD patients should mirror that for patients who have colorectal cancer."

"This would suggest a change in clinical practice to extend out-of-hospital prophylaxis for 4 weeks in postoperative IBD patients."

Dis Colon Rectum 2014: 57(4): 482–489
27 March 2014

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