title: Can sepsis predict deep venous thrombosis in colorectal surgery?
abstract: BACKGROUND
  Little data exist regarding the impact of sepsis on deep venous thrombosis (DVT) in colorectal surgery patients. We sought to elucidate this relationship.
  
  
  METHODS
  Current Procedural Terminology codes were used to identify patients who underwent colorectal surgery as reported to the National Surgical Quality Improvement Program in 2010. The relationship between DVT and sepsis was then explored in a matched population.
  
  
  RESULTS
  Of the 26,554 patients who underwent colorectal surgery, 462 (1.7%) developed a DVT. The largest dependent correlations with DVT were malnutrition (33% vs 57%), emergency operation (15% vs 31%), open operation (58% vs 78%), and prolonged ventilator requirement (5% vs 24%; all P < .001). After propensity score matching, urosepsis (.5% vs 1.9%), organ/space sepsis (1.1% vs 4.8%), pneumosepsis (.5% vs 5.8%), and overall perioperative sepsis (18% vs 39%; all P ≤ .04) were associated with DVT. The strongest independent predictor of DVT was pneumosepsis (odds ratio 15.9, 95% confidence interval 3.7 to 67.2, P < .001).
  
  
  CONCLUSIONS
  Perioperative sepsis is a significant risk factor for postoperative DVT in the colorectal surgery population.
authors.affiliation: Department of Surgery, Madigan Army Medical Center, 9040 Jackson Avenue, Tacoma, WA 98431, USA. Electronic address: qhatch@gmail.com.
authors.forename: Quinton
authors.initials: Q
authors.lastname: Hatch
authors.affiliation: Department of Surgery, Madigan Army Medical Center, 9040 Jackson Avenue, Tacoma, WA 98431, USA.
authors.forename: Daniel
authors.initials: D
authors.lastname: Nelson
authors.affiliation: Department of Surgery, Madigan Army Medical Center, 9040 Jackson Avenue, Tacoma, WA 98431, USA.
authors.forename: Matthew
authors.initials: M
authors.lastname: Martin
authors.affiliation: Division of Colorectal Surgery, Department of Surgery, University of Massachusetts Memorial Medical Center, Worcester, MA, USA.
authors.forename: Justin A
authors.initials: JA
authors.lastname: Maykel
authors.affiliation: Department of Surgery, Madigan Army Medical Center, 9040 Jackson Avenue, Tacoma, WA 98431, USA.
authors.forename: Eric K
authors.initials: EK
authors.lastname: Johnson
authors.affiliation: Division of Colorectal Surgery, Department of Surgery, Case Medical Center, Cleveland, OH, USA.
authors.forename: Bradley J
authors.initials: BJ
authors.lastname: Champagne
authors.affiliation: Department of Surgery, University of Chicago Medicine, Chicago, IL, USA.
authors.forename: Neil H
authors.initials: NH
authors.lastname: Hyman
authors.affiliation: Department of Surgery, Madigan Army Medical Center, 9040 Jackson Avenue, Tacoma, WA 98431, USA.
authors.forename: Scott R
authors.initials: SR
authors.lastname: Steele
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003082:Colectomy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D059035:Perioperative Period; D011183:Postoperative Complications / Q000209:etiology*; D057216:Propensity Score; D012007:Rectum / Q000601:surgery*; D012189:Retrospective Studies; D012307:Risk Factors; D018805:Sepsis / Q000150:complications*; D020246:Venous Thrombosis / Q000209:etiology*; D055815:Young Adult
keywords: Colorectal; Deep venous thrombosis; Sepsis; Surgery