Department of Surgery, University of Connecticut Health Center, Farmington, CT, 06030, USA.
Colon and Rectal Surgeons of Greater Hartford, Bloomfield, CT, 06002, USA.
Surg Endosc. 2022 Nov;36(11):8415-8420. doi: 10.1007/s00464-022-09129-6. Epub 2022 Feb 28.
Following colorectal surgery, venous thromboembolism (VTE) is a serious complication occurring at an estimated incidence of 2-4%. There is a significant body of literature stratifying risk of VTE in specific populations undergoing colorectal resection for cancer or inflammatory bowel disease. There has been little research characterizing patients undergoing colorectal surgery for other indications, e.g. diverticulitis. We hypothesize that there exists a subgroup of patients with identifiable risk factors undergoing resection for diverticulitis that has relatively higher risks for VTE. We conducted a retrospective review of the American College of Surgeons National Surgical Quality Improvement Project database from 2006 to 2017 who underwent colorectal resection for diverticulitis. Patients with a primary indication for resection other than diverticulitis were excluded. Multivariate logistic regression modeling was conducted to determine the risk of VTE for each independent variable. A novel scoring system was developed and a receiver-operating-characteristic curve was generated. The rate of VTE was 1.49%. An 7-point scoring system was developed using identified significant variables. Patients scoring ≥ 6 on the developed scoring scale had a 3.12% risk of 30-day VTE development. A simple scoring system based on identified significant risk factors was specifically developed to predict the risk of VTE in patients undergoing diverticular colorectal resection. These patients are at significantly higher risk and may justify increased vigilance regarding VTE events, similar to patients undergoing colorectal resection for cancer or inflammatory bowel disease.
结直肠手术后,静脉血栓栓塞症(VTE)是一种严重的并发症,估计发生率为 2-4%。有大量文献对接受结直肠切除术治疗癌症或炎症性肠病的特定人群的 VTE 风险进行了分层。对于因其他指征(如憩室炎)接受结直肠手术的患者,研究甚少。我们假设,在因憩室炎接受切除术的患者中存在具有可识别风险因素的亚组,其 VTE 风险相对较高。我们对 2006 年至 2017 年期间接受憩室炎结直肠切除术的美国外科医师学院国家外科质量改进计划数据库进行了回顾性研究。排除了以憩室炎以外的主要指征接受切除术的患者。采用多变量逻辑回归模型确定每个独立变量的 VTE 风险。开发了一种新的评分系统并生成了接收者操作特征曲线。VTE 的发生率为 1.49%。使用确定的显著变量开发了一个 7 分评分系统。在开发的评分量表上得分≥6 的患者,30 天内 VTE 发展的风险为 3.12%。专门开发了一种基于确定的显著危险因素的简单评分系统,以预测接受憩室性结直肠切除术的患者的 VTE 风险。这些患者的风险显著更高,可能需要更加警惕 VTE 事件,类似于因癌症或炎症性肠病而接受结直肠切除术的患者。