Extended Venous Thromboembolism Prophylaxis After Elective Surgery for IBD Patients: Nomogram-Based Risk Assessment and Prediction from Nationwide Cohort

Benlice, Çiğdem; Holubar, Stefan D.; Görgün, Emre; Stocchi, Luca; Lipman, Jeremy M.; Kalady, Matthew F.; Champagne, Bradley J.; Steele, Scott R.

doi:10.1097/dcr.0000000000001189

Cited by 42 publications

(62 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The median length of follow‐up was 1 month. Importantly, IBD patients were at greatest risk of VTE in the first two postoperative weeks . In one of the included studies, 61% of the postdischarge VTEs occurred within 2 weeks following discharge [mean length of stay (LOS) 6.9 days] . How does the risk of VTE in patients undergoing colorectal surgery for IBD compare with that of patients undergoing colorectal surgery for other indications?Three studies showed higher postoperative VTE rates when colorectal surgery was performed for IBD than for diverticular disease (Fig.…”

Section: Resultsmentioning

confidence: 99%

“…Nonetheless, comparisons on the basis of specific operations are lacking in the current literature. Is there a difference in postoperative VTE incidence in patients with Crohn's disease (CD) and patients with UC?Seven studies directly compared the incidence of postoperative VTE between UC and CD patients (Fig. ) . The majority of studies (86%) showed a significantly higher rate of VTE in UC patients than in CD patients.…”

Section: Resultsmentioning

confidence: 99%

“…The study by Benlice et al . was the only study that failed to show a significant difference in VTE rates between UC and CD (2.7% vs 2.3%, respectively), yet it was the only study that observed the majority of VTE events in hospital. Robinson et al .…”

Section: Resultsmentioning

confidence: 99%

“…Furthermore, none of the studies compared the effectiveness of pharmacological thromboprophylaxis between UC and CD patients. Nonetheless, all IBD patients remain at an increased relative risk of VTE postoperatively and postdischarge, and therefore warrant consideration for extended pharmacological thromboprophylaxis . What surgical risk factors affect the rates of VTE in IBD patients undergoing colorectal surgery?Several studies identified specific colorectal operations that increased the risk of postoperative VTE (Table ). Operations that were associated with a high risk of postoperative VTE included proctocolectomy, TPC with ileal pouch–anal anastomosis, proctectomy, TAC with ileostomy and subtotal colectomy with colostomy or ileostomy and creation of a mucous fistula .…”

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Extended thromboprophylaxis following colorectal surgery in patients with inflammatory bowel disease: a comprehensive systematic clinical review

et al. 2019

View full text Add to dashboard Cite

Aim Patients with inflammatory bowel disease (IBD) are at increased risk of postoperative venous thromboembolism (VTE) following major abdominal surgery. The pathogenesis is multifactorial and not fully understood. A combination of pathophysiology, patient and surgical risk factors increase the risk of postoperative VTE in these patients. Despite being at increased risk, IBD patients are not regularly prescribed extended pharmacological thromboprophylaxis following colorectal surgery. Currently, there is a paucity of evidence‐based guidelines. Thus, the aim of this review is to evaluate the role of extended pharmacological thromboprophylaxis in IBD patients undergoing colorectal surgery. Method A search of Ovid Medline, EMBASE and PubMed databases was performed. A qualitative analysis was performed using 10 clinical questions developed by colorectal surgeons and a thrombosis haematologist. The Newcastle–Ottawa Scale was utilized to assess the quality of evidence. Results A total of 1229 studies were identified, 38 of which met the final inclusion criteria (37 retrospective, one case–control). Rates of postoperative VTE ranged between 0.6% and 8.9%. Patient‐specific risk factors for postoperative VTE included ulcerative colitis, increased age and obesity. Surgery‐specific risk factors for postoperative VTE included open surgery, emergent surgery and ileostomy creation. Patients with IBD were more frequently at increased risk in the included studies for postoperative VTE than patients with colorectal cancer. The risk of bias assessment demonstrated low risk of bias in patient selection and comparability, with variable risk of bias in reported outcomes. Conclusion There is a lack of evidence regarding the use of extended pharmacological thromboprophylaxis in patients with IBD following colorectal surgery. As these patients are at heightened risk of postoperative VTE, future study and consideration of the use of extended pharmacological thromboprophylaxis is warranted.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Extended thromboprophylaxis following colorectal surgery in patients with inflammatory bowel disease: a comprehensive systematic clinical review

et al. 2019

View full text Add to dashboard Cite

show abstract

“…[3][4][5] Traditionally, corticosteroids have been associated with VTE risk in IBD. Zeng and Gan for their interest in our study and thoughtful comments.…”

mentioning

confidence: 99%

Letter: previous exposure to corticosteroids increases the risk of post‐discharge venous thromboembolic events in patients with inflammatory bowel disease—author's reply

McCurdy

2019

Aliment Pharmacol Ther

View full text Add to dashboard Cite

show abstract

Essential updates 2018/2019: Colorectal (benign)

Ogino

Mizushima

Matsuda

et al. 2019

Annals of Gastroent Surgery

View full text Add to dashboard Cite

This review outlines current topics on the surgical treatment of benign colorectal diseases, with a focus on inflammatory bowel disease (IBD) and diverticulitis. Treatment options for IBD and diverticulitis have evolved in the last few years as a result of medical advances in technology and new clinical trials. Therefore, treatment options and strategies need to be updated to provide optimal care for patients. The purpose of this review is to elucidate recent global trends and update the surgical treatment strategy for IBD and diverticulitis based on literature published in the past 2 years. Prevalence of IBD, including ulcerative colitis and Crohn's disease, has increased over the last few decades. During this period, many new medical therapies were introduced for the treatment of IBD, including biological therapy, immunomodulators, and leukocyte apheresis therapy. As a result, new surgical strategies for IBD are required. In order to improve surgical outcomes in IBD patients, the influence of preoperative treatment on postoperative complications needs to be considered. The incidence of diverticulitis is also increasing with lifestyle changes and increasing numbers of older people. For diverticulitis with perforation and generalized peritonitis, surgery is the gold standard. Elective surgery after conservative treatment of diverticulitis is also an option because of high recurrence rates. With an increase in diverticulitis, systematic strategies are essential for an appropriate approach to diverticulitis, taking into account various factors, including the patient's background.

show abstract

Extended Venous Thromboembolism Prophylaxis After Elective Surgery for IBD Patients: Nomogram-Based Risk Assessment and Prediction from Nationwide Cohort

Cited by 42 publications

References 17 publications

Extended thromboprophylaxis following colorectal surgery in patients with inflammatory bowel disease: a comprehensive systematic clinical review

Extended thromboprophylaxis following colorectal surgery in patients with inflammatory bowel disease: a comprehensive systematic clinical review

Letter: previous exposure to corticosteroids increases the risk of post‐discharge venous thromboembolic events in patients with inflammatory bowel disease—author's reply

Essential updates 2018/2019: Colorectal (benign)

Contact Info

Product

Resources

About