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Incidence and Risk Factors for Venous Thromboembolism Events After Rectal Prolapse Surgery.
Sarah B Jochum1, Mikhael Belkovsky, Sarah Kirschling
1Department of Colon and Rectal Surgery, Cleveland Clinic Foundation, Cleveland, Ohio.
Diseases of the Colon and Rectum
|June 5, 2025
Summary
The incidence of venous thromboembolism after rectal prolapse surgery is very low (0.32%). Key risk factors include dependent functional status, longer hospital stay, surgical site infections, and bleeding. Further research is needed on chemoprophylaxis.
Area of Science:
- Colorectal surgery
- Vascular surgery
- Patient safety
Background:
- Venous thromboembolism (VTE) is a leading cause of preventable death in hospitalized patients.
- While VTE rates for pelvic organ prolapse surgery are reported as <1%, VTE rates after rectal prolapse surgery are largely undescribed.
- This study aimed to define the incidence and identify risk factors for VTE after rectal prolapse surgery.
Purpose of the Study:
- To determine the incidence of venous thromboembolism (VTE) events within 30 days post-rectal prolapse surgery.
- To identify independent risk factors associated with VTE development after rectal prolapse repair.
Main Methods:
- Retrospective analysis of 19,197 rectal prolapse procedures from the American College of Surgeons-National Surgical Quality Improvement Program (2005-2021).
- Utilized Current Procedural Terminology codes to identify eligible patients.
- Assessed incidence of VTE and associated risk factors through multivariable analysis.
Main Results:
- Overall VTE incidence was low at 0.32% (61/19,197 patients).
- Over 60% of VTE events occurred within two weeks post-surgery.
- Independent risk factors for VTE included dependent functional status (OR 2.62), longer length of stay (OR 1.048), postoperative surgical site infections (OR 3.59), and bleeding (OR 4.35).
Conclusions:
- Rectal prolapse repair has a very low incidence of VTE, comparable to pelvic organ prolapse surgery.
- Preoperative dependent functional status and postoperative complications like bleeding and surgical site infections are significant risk factors for VTE.
- Perioperative chemoprophylaxis use could not be assessed in this study.
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