Postoperative open abdomen creates highest risk for VTE in IBD patients
Multiple perioperative and operative factors increased the risk for venous thromboembolism in patients with inflammatory bowel disease, according to a presenter at the European Crohn’s and Colitis Organization.
“Patients undergoing colorectal surgery for IBD recognize increased risk of VTE,” Ju Yong Cheong, MD, a colorectal fellow in the department of colon and rectal surgery at the Cleveland Clinic in Ohio, said. “The aim of this study was to determine the perioperative risk factors for VTE and to create a predictive scoring system for VTE in these patients.”
Cheong and colleagues analyzed 5,003 patients (51.9% men, mean age 42.7 years) with IBD (57.3% Crohn’s disease, 42.7% ulcerative colitis) in the NSQIP-IBD registry from 2017 to 2020. Of 125 patients who developed VTE, a postoperative open abdomen correlated with the greatest risk for VTE development (OR = 2.69; P = .009). Additional risk factors included preoperative interhospital transfer (OR = 2.49; P < .001), sepsis (OR = 2.28; P = .001), ASA classification (grade 3-4 vs. grade 1-2: OR = 1.83; P = .004), UC diagnosis (OR = 1.72; P = .011) and serum sodium level ( 139 mmol/L: OR = 1.66; P = .022).
According to study results, the risk for VTE moderately increased with the presence of one to four risk factors (0.7%, 1.8%, 3.6% and 4.5%, respectively) and increased “exponentially” among patients who had five (10.9%) or six (25%) risk factors.
“There are cumulative risk factors which increase the risk for venous thromboembolism after surgery for inflammatory bowel disease; the risk increases exponentially with more than five risk factors,” Cheong concluded. “The limitation of this study is that it is not certain how many patients had extended chemoprophylaxis and inpatient chemoprophylaxis.”
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Cheong JY, et al. Abstract DOP29. Presented at: Congress of European Crohn’s and Colitis Organization; February 16-19, 2022 (virtual meeting).
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