Variation in the risk of venous thromboembolism following colectomy

Background: Guidelines recommend extended thromboprophylaxis following colectomy for malignant disease, but not for non-malignant disease. The aim of this study was to determine absolute and relative rates of venous thromboembolism (VTE) following colectomy by indication, admission type and time aft...

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Main Authors:	Humes, D.J., Walker, A.J., Blackwell, J., Hunt, B.J., West, Joe
Format:	Article
Language:	English
Published:	John Wiley & Sons, Ltd 2015
Online Access:	http://eprints.nottingham.ac.uk/38809/ http://eprints.nottingham.ac.uk/38809/ http://eprints.nottingham.ac.uk/38809/ http://eprints.nottingham.ac.uk/38809/1/BJS_mar_2016.pdf

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spelling	nottingham-388092018-06-26T12:37:27Z http://eprints.nottingham.ac.uk/38809/ Variation in the risk of venous thromboembolism following colectomy Humes, D.J. Walker, A.J. Blackwell, J. Hunt, B.J. West, Joe Background: Guidelines recommend extended thromboprophylaxis following colectomy for malignant disease, but not for non-malignant disease. The aim of this study was to determine absolute and relative rates of venous thromboembolism (VTE) following colectomy by indication, admission type and time after surgery. Methods: A cohort study of patients undergoing colectomy in England was undertaken using linked primary (Clinical Practice Research Datalink) and secondary (Hospital Episode Statistics) care data (2001–2011). Crude rates and adjusted hazard ratios (HRs) were calculated for the risk of first VTE following colectomy using Cox regression analysis. Results: Some 12 388 patients were identified; 312 (2·5 per cent) developed VTE after surgery, giving a rate of 29·59 (95 per cent c.i. 26·48 to 33·06) per 1000 person-years in the first year after surgery. Overall rates were 2·2-fold higher (adjusted HR 2·23, 95 per cent c.i. 1·76 to 2·50) for emergency compared with elective admissions (39·44 versus 25·78 per 1000 person-years respectively). Rates of VTE were 2·8-fold higher in patients with malignant disease versus those with non-malignant disease (adjusted HR 2·84, 2·04 to 3·94). The rate of VTE was highest in the first month after emergency surgery, and declined from 121·68 per 1000 person-years in the first month to 25·65 per 1000 person-years during the rest of the follow-up interval. Crude rates of VTE were similar for malignant and non-malignant disease (114·76 versus 120·98 per 1000 person-years respectively) during the first month after emergency surgery. Conclusion: Patients undergoing emergency colectomy for non-malignant disease have a similar risk of VTE as patients with malignant disease in the first month after surgery. John Wiley & Sons, Ltd 2015-12 Article PeerReviewed application/pdf en http://eprints.nottingham.ac.uk/38809/1/BJS_mar_2016.pdf Humes, D.J. and Walker, A.J. and Blackwell, J. and Hunt, B.J. and West, Joe (2015) Variation in the risk of venous thromboembolism following colectomy. British Journal of Surgery, 102 (13). pp. 1629-1638. ISSN 1365-2168 http://onlinelibrary.wiley.com/doi/10.1002/bjs.9923/abstract doi:10.1002/bjs.9923 doi:10.1002/bjs.9923
repository_type	Digital Repository
institution_category	Local University
institution	University of Nottingham Malaysia Campus
building	Nottingham Research Data Repository
collection	Online Access
language	English
description	Background: Guidelines recommend extended thromboprophylaxis following colectomy for malignant disease, but not for non-malignant disease. The aim of this study was to determine absolute and relative rates of venous thromboembolism (VTE) following colectomy by indication, admission type and time after surgery. Methods: A cohort study of patients undergoing colectomy in England was undertaken using linked primary (Clinical Practice Research Datalink) and secondary (Hospital Episode Statistics) care data (2001–2011). Crude rates and adjusted hazard ratios (HRs) were calculated for the risk of first VTE following colectomy using Cox regression analysis. Results: Some 12 388 patients were identified; 312 (2·5 per cent) developed VTE after surgery, giving a rate of 29·59 (95 per cent c.i. 26·48 to 33·06) per 1000 person-years in the first year after surgery. Overall rates were 2·2-fold higher (adjusted HR 2·23, 95 per cent c.i. 1·76 to 2·50) for emergency compared with elective admissions (39·44 versus 25·78 per 1000 person-years respectively). Rates of VTE were 2·8-fold higher in patients with malignant disease versus those with non-malignant disease (adjusted HR 2·84, 2·04 to 3·94). The rate of VTE was highest in the first month after emergency surgery, and declined from 121·68 per 1000 person-years in the first month to 25·65 per 1000 person-years during the rest of the follow-up interval. Crude rates of VTE were similar for malignant and non-malignant disease (114·76 versus 120·98 per 1000 person-years respectively) during the first month after emergency surgery. Conclusion: Patients undergoing emergency colectomy for non-malignant disease have a similar risk of VTE as patients with malignant disease in the first month after surgery.
format	Article
author	Humes, D.J. Walker, A.J. Blackwell, J. Hunt, B.J. West, Joe
spellingShingle	Humes, D.J. Walker, A.J. Blackwell, J. Hunt, B.J. West, Joe Variation in the risk of venous thromboembolism following colectomy
author_facet	Humes, D.J. Walker, A.J. Blackwell, J. Hunt, B.J. West, Joe
author_sort	Humes, D.J.
title	Variation in the risk of venous thromboembolism following colectomy
title_short	Variation in the risk of venous thromboembolism following colectomy
title_full	Variation in the risk of venous thromboembolism following colectomy
title_fullStr	Variation in the risk of venous thromboembolism following colectomy
title_full_unstemmed	Variation in the risk of venous thromboembolism following colectomy
title_sort	variation in the risk of venous thromboembolism following colectomy
publisher	John Wiley & Sons, Ltd
publishDate	2015
url	http://eprints.nottingham.ac.uk/38809/ http://eprints.nottingham.ac.uk/38809/ http://eprints.nottingham.ac.uk/38809/ http://eprints.nottingham.ac.uk/38809/1/BJS_mar_2016.pdf
first_indexed	2018-09-06T12:54:46Z
last_indexed	2018-09-06T12:54:46Z
_version_	1610862807479222272

Variation in the risk of venous thromboembolism following colectomy

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