Duration and Magnitude of Postoperative Risk of Venous Thromboembolism after Cholecystectomy: A Population-Based Cohort Study

Henry, M.L.; Abdul-Sultan, A.; Walker, A.J.; West, J.; Humes, D.J.

Abstract

Background:
This study aimed to identify burden and risk of VTE associated with cholecystectomy in England.

Methods:
An historical cohort study of cholecystectomy patients from 2001-2011 was undertaken using linked primary (Clinical Practice Research Datalink) and secondary (Hospital Episode Statistics) care data. Crude rates and adjusted hazard ratios (HRs) were calculated for risk of VTE following cholecystectomy using Cox regression.

Results:
24 677 patients were identified with a rate of VTE in the first year following cholecystectomy of 2.80 per 1000 person years (95% CI 2.18-3.59). Patients aged >/=70 vs aged 30 vs BMI less than 0 had 2.4-fold increase in risk (HR 2.42, 95% CI 1.40–4.18); open vs. laparoscopic operation had 3-fold increase in risk (HR 2.94, 95% CI 1.55–5.55). Compared to general population, VTE risk was the highest in the first 30 days post-operatively with 9.9-fold risk following emergency cholecystectomy and 4.5-fold risk after inpatient cholecystectomy (HR 9.90, 95% CI 4.42–22.21; HR 4.54, 95% CI 2.85–7.21).

Conclusions: Cholecystectomy is associated with a low absolute risk of VTE and we have identified high risk groups including the elderly, obese and those having open surgery.

Citation

Henry, M., Abdul-Sultan, A., Walker, A., West, J., & Humes, D. (2019). Duration and Magnitude of Postoperative Risk of Venous Thromboembolism after Cholecystectomy: A Population-Based Cohort Study. Digestive Surgery, 37(1), 32-38. https://doi.org/10.1159/000496435

• Journal Article Type: Article
• Acceptance Date: Dec 19, 2018
• Online Publication Date: Apr 3, 2019
• Publication Date: Apr 3, 2019
• Deposit Date: May 3, 2019
• Publicly Available Date: May 13, 2019
• Journal: Digestive Surgery
• Print ISSN: 0253-4886
• Electronic ISSN: 1421-9883
• Publisher: Karger Publishers
• Peer Reviewed: Peer Reviewed
• Volume: 37
• Issue: 1
• Pages: 32-38
• DOI: https://doi.org/10.1159/000496435
• Keywords: Surgery; Gastroenterology
• Public URL: https://nottingham-repository.worktribe.com/output/2018082
• Publisher URL: https://www.karger.com/Article/Abstract/496435
• Contract Date: May 3, 2019