A novel scoring system for identifying patients at risk for venous thromboembolism undergoing diverticular resection: an American College of Surgeons-National Surgical Quality Improvement Program Study

Poulos, Constantine M.; Althoff, Ashley; Scott, Robert G.; Wakefield, Dorothy; Lewis, Robert K.

doi:10.1007/s00464-022-09129-6

Cited by 3 publications

(4 citation statements)

References 16 publications

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“…[6][7][8][9] Welldescribed perioperative risk factors include preoperative hospitalization, emergency surgery, BMI >35 kg/m 2 , corticosteroid use, comorbidities, anastomotic leak, ileus, and return to the operative room. [10][11][12][13][14] Intraoperative risk factors include more distal resections and prolonged or extensive operations, whereas a minimally invasive surgical approach is protective. 9,10,12,[14][15][16][17][18][19] Underlying disease diagnoses are another important contributor to VTE risk in patients undergoing colorectal surgery.…”

Section: Statement Of the Problemmentioning

confidence: 99%

The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the Reduction of Venous Thromboembolic Disease in Colorectal Surgery

Patel

Liberman

Burgess

et al. 2023

Diseases of the Colon &Amp; Rectum

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Section: Statement Of the Problemmentioning

confidence: 99%

The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the Reduction of Venous Thromboembolic Disease in Colorectal Surgery

Patel

Liberman

Burgess

et al. 2023

Diseases of the Colon &Amp; Rectum

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“…Current literature reports patients with diverticular disease and those undergoing colorectal surgery, especially as an emergency procedure are at a greater risk of postoperative venous thromboembolism (VTE) [8][9][10][11]. Therefore, VTE rates are expected to be high in this group [12]. However, recent changes in perioperative care such as the increased use of Minimally Invasive Surgery (MIS) and Enhanced Recovery After Surgery (ERAS) guidelines may have affected VTE risk.…”

Section: Introductionmentioning

confidence: 99%

“…Existing studies explore VTE rates following colectomy [16][17][18][19] however, reports on VTE following surgical management of diverticular disease are scarce. This novel study uses longer follow up timeframes as well as explores the effect of MIS techniques on colectomy for diverticular disease to supplement the current literature [9,12,[20][21][22][23][24]. The aim of this study was to explore the rates of VTE in patients undergoing surgery for diverticular disease and determine at risk subgroups to inform current guidelines.…”

Section: Introductionmentioning

confidence: 99%

“…had shorter investigation periods and only included in-patient VTE events. More recently, a large quality improvement project by Poulos et al explored likely subgroups at increased risk of VTE following diverticular resection[12]. Over an 11 year period, they too found emergency surgery and age > 65 to be signi cant predictors of VTE events.Elective SurgeryThere are no prior studies speci cally addressing the VTE risk following elective surgery in patients with diverticular disease.…”

mentioning

confidence: 99%

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Venous Thromboembolism Following Colectomy for Diverticular Disease

Yapa¹,

Humes

Crooks

et al. 2022

Preprint

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Aim This study reports venous thromboembolism (VTE) rates following colectomy for diverticular disease to explore the magnitude of postoperative VTE risk in this population and identify high risk subgroups of interest. Method English national cohort study of colectomy patients between 2000–2019 using linked primary (Clinical Practice Research Datalink) and secondary (Hospital Episode Statistics) care data. Stratified by admission type, absolute incidence rates (IR) per 1,000 person-years and adjusted incidence rate ratios (aIRR) were calculated for 30- and 90-day post-colectomy VTE. Results Of 24,394 patients who underwent colectomy for diverticular disease, over half (57.39%) were emergency procedures with the highest VTE rate seen in patients ≥ 70 years-old (IR 142.27 per 1,000 person-years, 95%CI 118.32-171.08) at 30-days post colectomy. Emergency resections (IR 135.18 per 1,000 person-years, 95%CI 115.72-157.91) had double the risk (aIRR 2.07, 95%CI 1.47–2.90) of developing a VTE at 30 days following colectomy compared to elective resections (IR 51.14 per 1,000 person-years, 95%CI 38.30-68.27). Minimally invasive surgery (MIS) was shown to be protective with a 64% reduction in VTE risk (aIRR 0.36 95%CI 0.20–0.65) compared to open colectomies at 30-days post-op. At 90 days following emergency resections, VTE risks remained raised compared to elective colectomies. Conclusion Following emergency colectomy for diverticular disease, the VTE risk is approximately double compared to elective resections at 30-days while MIS was found to reduce the risk of VTE. This suggests advancements in postoperative VTE prevention in diverticular disease patients, such as extended VTE prophylaxis, should focus on those undergoing emergency colectomies, particularly in elderly patients, as well as increasing the uptake of minimally invasive techniques.

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Venous thromboembolism following colectomy for diverticular disease: an English population-based cohort study

Yapa

Humes

Crooks

et al. 2023

Langenbecks Arch Surg

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Aim This study reports venous thromboembolism (VTE) rates following colectomy for diverticular disease to explore the magnitude of postoperative VTE risk in this population and identify high risk subgroups of interest. Method English national cohort study of colectomy patients between 2000 and 2019 using linked primary (Clinical Practice Research Datalink) and secondary (Hospital Episode Statistics) care data. Stratified by admission type, absolute incidence rates (IR) per 1000 person-years and adjusted incidence rate ratios (aIRR) were calculated for 30- and 90-day post-colectomy VTE. Results Of 24,394 patients who underwent colectomy for diverticular disease, over half (57.39%) were emergency procedures with the highest VTE rate seen in patients ≥70-years-old (IR 142.27 per 1000 person-years, 95%CI 118.32–171.08) at 30 days post colectomy. Emergency resections (IR 135.18 per 1000 person-years, 95%CI 115.72–157.91) had double the risk (aIRR 2.07, 95%CI 1.47–2.90) of developing a VTE at 30 days following colectomy compared to elective resections (IR 51.14 per 1000 person-years, 95%CI 38.30–68.27). Minimally invasive surgery (MIS) was shown to be associated with a 64% reduction in VTE risk (aIRR 0.36 95%CI 0.20–0.65) compared to open colectomies at 30 days post-op. At 90 days following emergency resections, VTE risks remained raised compared to elective colectomies. Conclusion Following emergency colectomy for diverticular disease, the VTE risk is approximately double compared to elective resections at 30 days while MIS was found to be associated with a reduced risk of VTE. This suggests advancements in postoperative VTE prevention in diverticular disease patients should focus on those undergoing emergency colectomies.

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A novel scoring system for identifying patients at risk for venous thromboembolism undergoing diverticular resection: an American College of Surgeons-National Surgical Quality Improvement Program Study

Cited by 3 publications

References 16 publications

The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the Reduction of Venous Thromboembolic Disease in Colorectal Surgery

The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the Reduction of Venous Thromboembolic Disease in Colorectal Surgery

Venous Thromboembolism Following Colectomy for Diverticular Disease

Venous thromboembolism following colectomy for diverticular disease: an English population-based cohort study

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