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Thromboembolic Complications and Prophylaxis Patterns in Colorectal Surgery.
, Daniel W Nelson1, Vlad V Simianu2
1Madigan Army Medical Center, Department of Surgery, Fort Lewis, Washington.
JAMA Surgery
|June 11, 2015
Summary
Venous thromboembolism (VTE) rates after colorectal surgery remain low and unchanged, despite increased use of VTE prophylaxis. Risk factors include older age, nonelective surgery, and inflammatory disease.
Area of Science:
- General Surgery
- Vascular Surgery
- Thrombosis Research
Background:
- Venous thromboembolism (VTE) is a significant complication following colorectal surgery.
- The incidence of VTE in the era of prophylaxis is not well-defined.
Purpose of the Study:
- To determine the incidence of thromboembolic complications after colorectal surgery.
- To identify risk factors associated with VTE.
- To describe contemporary VTE prophylaxis patterns.
Main Methods:
- Prospective data collection from 52 hospitals in Washington State (2006-2011).
- Inclusion of 16,120 patients undergoing colorectal surgery.
- Analysis of in-hospital and 90-day VTE complications.
Main Results:
- VTE prophylaxis use increased significantly from 2006 to 2011.
- The overall incidence of VTE was 2.2%.
- Abdominal operations, older age, nonelective surgery, history of VTE, and operations for inflammatory disease were associated with higher VTE risk.
Conclusions:
- VTE rates are low and have not decreased despite increased prophylaxis.
- Current data should inform future VTE prophylaxis guidelines for colorectal surgery.
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