Background/PurposeChildren with inflammatory bowel disease (IBD) have increased risk for venous thromboembolism (VTE). We sought to determine incidence and risk factors for postoperative VTE in a multicenter cohort of pediatric patients undergoing colorectal resection for IBD. Methods Retrospective review of children ≤18yrs who underwent colorectal resection for IBD from 2010-2016 was performed at four children's hospitals. Primary outcome was VTE that occurred between surgery and last follow-up. Factors associated with VTE were determined using univariable and multivariable analyses.
ResultsTwo-hundred-and-seventy-six patients were included with median age 15yrs [13,17]. Forty-two children (15%) received perioperative VTE chemoprophylaxis, and 88 (32%) received mechanical prophylaxis. DVT occurred in 12 patients (4.3%) at a median of 14 days postoperatively [8,147]. Most were portomesenteric (n=9, 75%) with the remaining catheter-associated DVTs in extremities (n=3, 25%). There was no association with chemoprophylaxis (p>0.99). On Cox regression, emergent procedure [HR 18.8,[95][96][97][98][99][100][101][102][103][104][105][106][107][108][109][110][111], perioperative plasma transfusion [HR 25.1,, and postoperative infectious complication [HR 10.5,] remained predictive of DVT.
ConclusionLess than 5% of pediatric IBD patients developed postoperative VTE. Chemoprophylaxis was not protective but rarely used. Patients with risk factors identified in this study should be monitored or given prophylaxis for VTE.