Venous thromboembolism following colorectal resection

Area of Science:

• General Surgery
• Vascular Surgery
• Oncology

Background:

• Venous thromboembolism (VTE) is a significant complication following colorectal resection.
• Understanding VTE rates and risk factors is crucial for optimizing patient outcomes and prophylaxis strategies.

Purpose of the Study:

• To investigate the incidence of VTE after colorectal resection during hospitalization and up to one year post-discharge.
• To identify independent risk factors for VTE in this patient population.
• To evaluate the optimal duration of VTE prophylaxis.

Main Methods:

• Retrospective analysis of 35,997 adult patients undergoing colorectal resection in England (April 2007-March 2008) using Hospital Episode Statistics.
• Patients were monitored during their index admission and for one year post-discharge for VTE events (deep venous thrombosis or pulmonary embolism) via readmission data.
• Statistical analysis identified risk factors and assessed VTE risk duration based on disease type.

Main Results:

• The overall VTE rate was 2.3%, with 0.56% occurring during the index admission and 1.72% post-discharge.
• VTE risk remained elevated for 6 months in cancer patients versus 2 months in benign disease patients post-discharge.
• Independent risk factors for VTE included age, prolonged postoperative stay, cancer, emergency admission, and emergency surgery for inflammatory bowel disease (IBD).

Conclusions:

• The majority of VTE events occur after hospital discharge, highlighting the need for extended prophylaxis in certain groups.
• Emergency surgery for IBD presents an additional VTE risk.
• A stratified approach to VTE prophylaxis, considering factors like cancer, emergency IBD surgery, and extended hospital stay, is recommended to reduce VTE incidence.