Venous thromboembolism rates low after colorectal surgery
Daniel W. Nelson, D.O., from the Madigan Army Medical Center in Fort Lewis, Wash., and colleagues describe the incidence of and risk factors associated with thromboembolic complications and contemporary VTE prophylaxis patterns following colorectal surgery. Data were included for 16,120 patients (mean age, 61.4 years) who underwent colorectal surgery at 52 Washington State Surgical Care and Outcomes Assessment Program hospitals from 2006 through 2011.
The researchers found that by 2011 there was a significant increase in perioperative and in-hospital VTE chemoprophylaxis (from 31.6 to 86.4 percent and from 59.6 to 91.4 percent, respectively; both P < 0.001); 10.6 percent were discharged on a chemoprophylaxis regimen. The overall VTE incidence was 2.2 percent. The rates of 90-day VTE were higher for patients undergoing abdominal operations versus pelvic operations (2.5 versus 1.8 percent; P = 0.001). The incidence of VTE was similar for those having an operation for cancer versus those having an operation for nonmalignant processes (2.1 versus 2.3 percent; P = 0.24). The risk of 90-day VTE was increased with older age, nonelective surgery, history of VTE, and operations for inflammatory disease (all P < 0.05). VTE did not decrease significantly over time.
"Venous thromboembolism rates are low and largely unchanged despite increases in perioperative and postoperative prophylaxis," the authors write. "These data should be considered in developing future guidelines."
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