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Journal of Gastrointestinal Surgery

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17-11-2022 | Ulcerative Colitis | Original Article

Are IBD Patients Underscored when Determining Postoperative VTE Risk?

Authors: Ana Sofia Ore, Carolina Vigna, Anne Fabrizio, Thomas E. Cataldo, Evangelos Messaris, Kristen Crowell

Published in: Journal of Gastrointestinal Surgery | Issue 2/2023

Abstract

Background

Patients with inflammatory bowel disease (IBD) have an increased risk of venous thromboembolism (VTE) following colorectal surgery and there is currently no consensus on post-surgical VTE prevention or specific VTE risk assessment tools. We sought to evaluate VTE risk after colorectal surgery and determine if known risk factors used in risk assessment tools adequate correlate with VTE risk in IBD patients.

Methods

Retrospective cohort study using the National Surgical Quality Improvement Project (NSQIP) Participant User File from 2010 to 2018.

Results

A total of 27,679 patients were included; 19,015 (68.7%) had Crohn’s disease (CD) and 8664 (31.3%) ulcerative colitis (UC). Of these, 16,749 (60.5%) underwent abdominopelvic procedures, 10,178 (36.8%) complex pelvic procedures, and 752 (2.7%) small bowel operations. The overall VTE rate was 2.3%. The VTE rate in patients with CD and UC was 1.8% and 3.6% (p < 0.001) respectively. Overall median time to VTE was 9 days after surgery. VTE rate was highest in patients who underwent complex pelvic procedures (3.6%; 361/10,178). A risk score was calculated using 16/40 available variables from the Caprini VTE Risk Assessment tool; risk score ranged from 3 to 12 points. Most patients that developed a VTE had a score between 3 and 5 points (75.6%), and only 24.5% had a score of 6 or higher. Patients with higher risk scores did not have a higher VTE incidence.

Conclusion

Post-surgical VTE rates are high in IBD patients. Over half of the events occurred following discharge and in patients with an apparent low-risk score. Additional studies are warranted to define a recommended postoperative VTE prophylaxis regimen for patients with IBD.

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Title: Are IBD Patients Underscored when Determining Postoperative VTE Risk?
Authors: Ana Sofia Ore
Carolina Vigna
Anne Fabrizio
Thomas E. Cataldo
Evangelos Messaris
Kristen Crowell
Publication date: 17-11-2022
Publisher: Springer US
Keywords: Ulcerative Colitis
Crohn's Disease
Chronic Inflammatory Bowel Disease
Published in: Journal of Gastrointestinal Surgery / Issue 2/2023
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI: https://doi.org/10.1007/s11605-022-05525-4

At a glance: The STEP trials

Springer Medicine

Are IBD Patients Underscored when Determining Postoperative VTE Risk?

Abstract

Background

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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