Risk of symptomatic venous thromboembolism following emergency appendicectomy in adults

BACKGROUND: Appendicectomy is the commonest intra-abdominal emergency surgical procedure, and little is known regarding the magnitude and timing of the risk of venous thromboembolism (VTE) after surgery. This study aimed to determine absolute and relative rates of symptomatic VTE following emergency...

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Main Authors: Humes, David, Walker, Alex J., Hunt, B.J., Sultan, Alyshah Abdul, Ludvigsson, Jonas F., West, Joe
Format: Article
Published: John Wiley & Sons, Ltd 2016
Online Access:https://eprints.nottingham.ac.uk/44770/
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author Humes, David
Walker, Alex J.
Hunt, B.J.
Sultan, Alyshah Abdul
Ludvigsson, Jonas F.
West, Joe
author_facet Humes, David
Walker, Alex J.
Hunt, B.J.
Sultan, Alyshah Abdul
Ludvigsson, Jonas F.
West, Joe
author_sort Humes, David
building Nottingham Research Data Repository
collection Online Access
description BACKGROUND: Appendicectomy is the commonest intra-abdominal emergency surgical procedure, and little is known regarding the magnitude and timing of the risk of venous thromboembolism (VTE) after surgery. This study aimed to determine absolute and relative rates of symptomatic VTE following emergency appendicectomy. METHODS: A cohort study was undertaken using linked primary (Clinical Practice Research Datalink) and secondary (Hospital Episode Statistics) care data of patients who had undergone emergency appendicectomy from 2001 to 2011. Crude rates and adjusted incidence rate ratios (IRRs) for VTE were calculated using Poisson regression, compared with baseline risk in the year before appendicectomy. RESULTS: A total of 13 441 patients were identified, of whom 56 (0.4 per cent) had a VTE in the first year after surgery. The absolute rate of VTE was highest during the in-hospital period, with a rate of 91.29 per 1000 person-years, which was greatest in those with a length of stay of 7 days or more (267.12 per 1000 person-years). This risk remained high after discharge, with a 19.1- and 6.6-fold increased risk of VTE in the first and second months respectively after discharge, compared with the year before appendicectomy (adjusted IRR: month 1, 19.09 (95 per cent c.i. 9.56 to 38.12); month 2, 6.56 (2.62 to 16.44)). CONCLUSION: The risk of symptomatic VTE following appendicectomy is relatively high during the in-hospital admission and remains increased after discharge. Trials of extended thromboprophylaxis are warranted in patients at particularly high risk.
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spelling nottingham-447702020-05-04T20:03:29Z https://eprints.nottingham.ac.uk/44770/ Risk of symptomatic venous thromboembolism following emergency appendicectomy in adults Humes, David Walker, Alex J. Hunt, B.J. Sultan, Alyshah Abdul Ludvigsson, Jonas F. West, Joe BACKGROUND: Appendicectomy is the commonest intra-abdominal emergency surgical procedure, and little is known regarding the magnitude and timing of the risk of venous thromboembolism (VTE) after surgery. This study aimed to determine absolute and relative rates of symptomatic VTE following emergency appendicectomy. METHODS: A cohort study was undertaken using linked primary (Clinical Practice Research Datalink) and secondary (Hospital Episode Statistics) care data of patients who had undergone emergency appendicectomy from 2001 to 2011. Crude rates and adjusted incidence rate ratios (IRRs) for VTE were calculated using Poisson regression, compared with baseline risk in the year before appendicectomy. RESULTS: A total of 13 441 patients were identified, of whom 56 (0.4 per cent) had a VTE in the first year after surgery. The absolute rate of VTE was highest during the in-hospital period, with a rate of 91.29 per 1000 person-years, which was greatest in those with a length of stay of 7 days or more (267.12 per 1000 person-years). This risk remained high after discharge, with a 19.1- and 6.6-fold increased risk of VTE in the first and second months respectively after discharge, compared with the year before appendicectomy (adjusted IRR: month 1, 19.09 (95 per cent c.i. 9.56 to 38.12); month 2, 6.56 (2.62 to 16.44)). CONCLUSION: The risk of symptomatic VTE following appendicectomy is relatively high during the in-hospital admission and remains increased after discharge. Trials of extended thromboprophylaxis are warranted in patients at particularly high risk. John Wiley & Sons, Ltd 2016-03 Article PeerReviewed Humes, David, Walker, Alex J., Hunt, B.J., Sultan, Alyshah Abdul, Ludvigsson, Jonas F. and West, Joe (2016) Risk of symptomatic venous thromboembolism following emergency appendicectomy in adults. British Journal of Surgery, 103 (4). pp. 443-450. ISSN 1365-2168 http://onlinelibrary.wiley.com/doi/10.1002/bjs.10091/abstract doi:10.1002/bjs.10091 doi:10.1002/bjs.10091
spellingShingle Humes, David
Walker, Alex J.
Hunt, B.J.
Sultan, Alyshah Abdul
Ludvigsson, Jonas F.
West, Joe
Risk of symptomatic venous thromboembolism following emergency appendicectomy in adults
title Risk of symptomatic venous thromboembolism following emergency appendicectomy in adults
title_full Risk of symptomatic venous thromboembolism following emergency appendicectomy in adults
title_fullStr Risk of symptomatic venous thromboembolism following emergency appendicectomy in adults
title_full_unstemmed Risk of symptomatic venous thromboembolism following emergency appendicectomy in adults
title_short Risk of symptomatic venous thromboembolism following emergency appendicectomy in adults
title_sort risk of symptomatic venous thromboembolism following emergency appendicectomy in adults
url https://eprints.nottingham.ac.uk/44770/
https://eprints.nottingham.ac.uk/44770/
https://eprints.nottingham.ac.uk/44770/