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

Yapa, Anjali K D S; Humes, David J; Crooks, Colin J; Lewis-Lloyd, Christopher A

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


Authors

Anjali K D S Yapa

DAVID HUMES david.humes@nottingham.ac.uk
Clinical Associate Professor

Christopher A Lewis-Lloyd



Abstract

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.

Citation

Yapa, A. K. D. S., Humes, D. J., Crooks, C. . J., & Lewis-Lloyd, C. A. (2023). Venous thromboembolism following colectomy for diverticular disease: an English population-based cohort study. Langenbeck's Archives of Surgery, 408, Article 203. https://doi.org/10.1007/s00423-023-02920-6

Journal Article Type Article
Acceptance Date Apr 29, 2023
Online Publication Date May 22, 2023
Publication Date May 22, 2023
Deposit Date Jul 21, 2023
Publicly Available Date Jul 24, 2023
Journal Langenbeck's Archives of Surgery
Print ISSN 1435-2443
Electronic ISSN 1435-2451
Publisher Springer Verlag
Peer Reviewed Peer Reviewed
Volume 408
Article Number 203
DOI https://doi.org/10.1007/s00423-023-02920-6
Keywords Colectomy, Venous thromboembolism, Emergency, Diverticular disease
Public URL https://nottingham-repository.worktribe.com/output/21363393
Publisher URL https://link.springer.com/article/10.1007/s00423-023-02920-6

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Venous thromboembolism following colectomy for diverticular disease: an English population-based cohort study (773 Kb)
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Publisher Licence URL
https://creativecommons.org/licenses/by/4.0/

Copyright Statement
Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.





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