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Massachusetts Chapter of the American College of Surgeons Massachusetts Chapter of the American College of Surgeons Massachusetts Chapter of the American College of Surgeons Massachusetts Chapter of the American College of Surgeons Massachusetts Chapter of the American College of Surgeons
57th Annual Meeting Abstracts


Poster 11

Abstract Title

Inflammatory Bowel Disease and Increased Risk of Postoperative DVT/PE: An analysis using the NSQIP

 

Author Block

Andrea Merrill BA1, Frederick H. Millham MD, MBA2

1 Tufts University,Boston, MA, USA 2 Newton-WellesleyHospital, Newton, MA, USA

 

Abstract Body

Background: It is known that patients with inflammatory bowel disease (IBD) have increased risk for deep vein thrombosis and/or pulmonary embolism (DVT/PE). Risk of postoperative DVT/PE in IBD patients undergoing GI and Non-GI surgery is not well understood.

Methods: We used 2008 puf files from the National Surgery Quality Improvement Project (NSQIP) to test the association of IBD with postoperative DVT/PE in GI surgery and Non-GI surgery. We tested the association of IBD with postoperative DVT/PE using univariate and multivariate models. The NSQIPs structure allowed for robust accounting for potential confounding variables. We also probed the risk of postoperative myocardial infarction (MI) and stroke using similar models.

Results: Of 268,703 NSQIP patients, 2,249 (0.8%) had IBD. There were 2,665 cases of DVT or PE (1%). DVT/PE was more common in patients with IBD (2.2%) overall (p<0.002). Non-GI surgical cases had a higher rate (5.2%, p<0.002). Regression analysis, controlling for confounders, confirmed IBD was associated with increased risk for DVT/PE (OR= 1.95, 95% CI 1.47-2.61). For Non-GI surgery, risk of DVT/PE for patients with IBD was increased (OR=3.23, 95% CI 1.16-8.95). IBD had no effect on risk of postoperative MI or stroke.

Conclusion: IBD patients are at increased risk for developing postoperative DVT/PE. This risk persists when potential confounding variables are controlled for. Risk of DVT/PE appears to be even higher for IBD patients who are having Non-GI Surgery. Cardiac and stroke risk do not appear to be increased by IBD. Perhaps standards for DVT prophylaxis in these cases should be reconsidered.

 

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