title: Ulcerative Colitis Is Associated With an Increased Risk of Venous Thromboembolism in the Postoperative Period: The Results of a Matched Cohort Analysis.
abstract: OBJECTIVE
  To determine the rates of venous thromboembolism (VTE) during admission and within 30 days of hospital discharge in inflammatory bowel (IBD) patients undergoing colonic resection using the ACS National Surgical Quality Improvement Project (NSQIP) database and to compare these rates to VTE rates in cohorts of patients undergoing colonic resection for several other colonic pathologies.
  
  
  BACKGROUND
  High rates of VTE have been demonstrated in hospitalized IBD patients. However, rates of postdischarge VTE in IBD patients are understudied.
  
  
  METHODS
  Demographic, operative, and outcomes data for 96,999 patients undergoing colonic resection for diverticulitis, colorectal cancer (CRC), benign neoplasms, ulcerative colitis (UC), and Crohn's disease (CD) between 2005 and 2011 was obtained. Student t and χ tests were used for univariate analysis. A logistic multivariate analysis was performed with all significant variables. Propensity score matching was utilized to compare the VTE incidences between the groups.
  
  
  RESULTS
  Highest VTE risk was seen in obese patients [odds ratio (OR) = 1.41], those older than 73 years (OR = 1.58) and with bleeding disorders (OR = 1.44), American Society of Anesthesiology class III/IV (OR = 1.52/1.86), preoperative systemic inflammatory response syndrome (OR = 1.55), sepsis (OR = 1.48) or steroid use (OR = 1.63), and primary diagnosis of UC (OR = 2.10). The UC group had the highest incidence of VTE (2.74%), followed by CRC patients (1.74%). A 1.2% incidence was seen in the CD population, and 41.5% of the UC-VTEs were diagnosed after discharge.
  
  
  CONCLUSIONS
  This study affirms that inpatient UC patients undergoing colonic resection are at high risk for VTE and suggests that this risk persists into the postdischarge period. Thus, these patients should be given appropriate prophylaxis.
authors.affiliation: *Department of Surgery †Division of Colon and Rectal Surgery ‡Division of Gastroenterology, Inflammatory Bowel Disease Center, Department of Surgery; and §Department of Public Health Sciences, College of Medicine, The Pennsylvania State University, Hershey, PA.
authors.forename: Matthew Z
authors.initials: MZ
authors.lastname: Wilson
authors.forename: Tara M
authors.initials: TM
authors.lastname: Connelly
authors.forename: Andrew
authors.initials: A
authors.lastname: Tinsley
authors.forename: Christopher S
authors.initials: CS
authors.lastname: Hollenbeak
authors.forename: Walter A
authors.initials: WA
authors.lastname: Koltun
authors.forename: Evangelos
authors.initials: E
authors.lastname: Messaris
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D003082:Colectomy / Q000009:adverse effects*; D003093:Colitis, Ulcerative / Q000150:complications / Q000601:surgery*; D016208:Databases, Factual; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D057216:Propensity Score; D012307:Risk Factors; D054556:Venous Thromboembolism / Q000209:etiology* / Q000517:prevention & control