Post‐Hospital Discharge Venous Thromboembolism in Colorectal Surgery

Abstract

Background There are limited data regarding the criteria for prophylactic treatment of venous thromboembolism (VTE) after hospital discharge. We sought to identify risk factors of post-hospital discharge VTE events following colorectal surgery.Methods The NSQIP database was utilized to examine patients developed VTE after hospital discharge following colorectal surgery during [2005][2006][2007][2008][2009][2010][2011][2012][2013]. Multivariate analysis using logistic regression was performed to quantify risk factors of VTE after discharge.Results We evaluated a total of 219,477 patients underwent colorectal resections. The overall incidence of VTE was 2.1 % (4556). 33.8 % (1541) of all VTE events occurred after hospital discharge. The length of postoperative hospitalization had a strong association with post-discharge VTE, with the highest risk in patients who were hospitalized for more than 1 week after operation (AOR 9.08, P\0.01). Other factors associated with post-discharge VTE included chronic steroid use (AOR 1.81, P\0.01), stage 4 colorectal cancer (AOR 1.40, P = 0.03), obesity (AOR 1.37, P\0.01), age[70 (AOR 1.21, P = 0.04), and open surgery (AOR 1.36, P\0.01). Patients who were hospitalized for more than 1 week after an open colorectal resections had a 12 times higher risk of post-discharge VTE event compared to patients hospitalized less than 4 days after a laparoscopic resection (AOR 12.34, P\0.01).Conclusions VTE is uncommon following colorectal resections; however, a significant proportion occurs after patients are discharged from the hospital (33.8 %). The length of postoperative hospitalization appears to have a strong association with post-discharge VTE. High-risk patients may benefit from continued VTE prophylaxis after discharge.

The risk of venous thromboembolism during and after hospitalisation in patients with inflammatory bowel disease activity

“…This is also supported by another study showing an excess risk of venous thromboembolism in those undergoing emergency surgery . The size of the risk of thromboembolism we found is consistent with other patients after major surgery, suggesting similar post‐operative risks in inflammatory bowel disease patients and in patients undergoing surgery for colorectal cancer …”

“…36 The size of the risk of thromboembolism we found is consistent with other patients after major surgery, suggesting similar post-operative risks in inflammatory bowel disease patients and in patients undergoing surgery for colorectal cancer. [36][37][38]…”

Venous thromboembolism in common laparoscopic abdominal surgical operations

“…Postoperative venous thromboembolism (VTE) is one of the most common post-surgical complications, which may have disastrous impacts on surgical outcomes. 1 VTE includes deep vein thrombosis (DVT) and pulmonary embolism (PE) and is one of the leading causes of morbidity and prolonged hospitalization in surgical patients, 2,3 and it has been accounted for 5e10% of all inhospital deaths in US. 4,5 Although, several VTE preventative guidelines and recommendation have been issued from different surgical societies, 6,7 recent publications demonstrated that there is an incremental trend for VTE occurrences.…”

Timing and Risk Factors Associated With Venous Thromboembolism After Lung Cancer Resection

“…Indeed, the burden of postdischarge VTE has been documented in subsets of patients undergoing resection for abdominal and pelvic malignant diseases, in which the use of extended VTE prophylaxis is founded on strong evidence [6,[18][19][20][21]. However, few studies have examined the association of these risk factors and the development of VTE in thoracic surgical patients.…”