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Perioperative Venous Thromboembolism in Ulcerative Colitis: A Multicenter Prospective Study in Japan
Michio Itabashi1, Hiroki Ikeuchi2, Hideaki Kimura3
1Department of Surgery, Institute of Gastroenterology, Tokyo Women's Medical University Hospital, Tokyo, Japan.
Crohn'S & Colitis 360
|February 13, 2023
Summary
Venous thromboembolism (VTE) affects 11.1% of ulcerative colitis (UC) patients undergoing surgery in Japan. Preoperative hospital stay and blood transfusions are significant risk factors for VTE.
Area of Science:
- Gastroenterology
- Vascular Surgery
- Epidemiology
Background:
- Inflammatory bowel disease (IBD), particularly ulcerative colitis (UC), is associated with an increasing prevalence of venous thromboembolism (VTE) in Asian populations.
- Surgery for UC is a known risk factor for VTE, yet prospective data from Asia remains limited.
- This study addresses the lack of prospective research on perioperative VTE following UC surgery in Japan.
Purpose of the Study:
- To determine the prevalence of perioperative venous thromboembolism (VTE) in patients undergoing surgery for ulcerative colitis (UC) in Japan.
- To identify significant risk factors associated with VTE in the perioperative period for UC surgery.
- To evaluate VTE-related mortality in this patient cohort.
Main Methods:
- A multicenter prospective study involving 134 patients with UC undergoing surgery between January 2013 and December 2014.
- Preoperative screening for VTE was conducted on all participants.
- Standard VTE prophylaxis protocols were implemented, and VTE prevalence, risk factors, and mortality were assessed perioperatively and during follow-up.
Main Results:
- The overall prevalence of perioperative VTE was 11.1% (15 patients) for deep vein thrombosis (DVT) and 0.7% (1 patient) for pulmonary embolism (PE); all cases were asymptomatic.
- A preoperative hospital length of stay exceeding 5 days significantly increased the risk of preoperative VTE (OR: 8.26, P=0.04).
- Perioperative blood transfusion was a significant risk factor for postoperative VTE (OR: 8.26, P=0.04), with 75% of postoperative DVTs occurring after day 14.
Conclusions:
- A significant proportion of ulcerative colitis (UC) patients undergoing surgery experience perioperative venous thromboembolism (VTE).
- Preoperative hospital stay and perioperative blood transfusion are identified as key risk factors.
- Vigilant, VTE-conscious perioperative management is crucial for Asian patients, mirroring practices in Western countries.
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