title: Venous thromboembolism following colorectal resection.
abstract: OBJECTIVE
  The study investigated the rate of significant venous thromboembolism (VTE) following colorectal resection during the index admission and over 1 year following discharge. It identifies risk factors associated with VTE and considers the length of VTE prophylaxis required.
  
  
  METHODS
  All adult patients who underwent colorectal resections in England between April 2007 and March 2008 were identified using Hospital Episode Statistics data. They were studied during the index admission and followed for a year to identify any patients who were readmitted as an emergency with a diagnosis of deep venous thrombosis or pulmonary embolism.
  
  
  RESULTS
  In all, 35 997 patients underwent colorectal resection during the period of study. The VTE rate was 2.3%. Two hundred and one (0.56%) patients developed VTE during the index admission and 571 (1.72%) were readmitted with VTE. Following discharge from the index admission, the risk of VTE in patients with cancer remained elevated for 6 months compared with 2 months in patients with benign disease. Age, postoperative stay, cancer, emergency admission and emergency surgery for patients with inflammatory bowel disease (IBD) were all independent risk factors associated with an increased risk of VTE. Patients with ischaemic heart disease and those having elective minimal access surgery appear to have lower levels of VTE.
  
  
  CONCLUSIONS
  This study adds to the benefits of minimal access surgery and demonstrates an additional risk to patients undergoing emergency surgery for IBD. The majority of VTE cases occur following discharge from the index admission. Therefore, surgery for cancer, emergency surgery for IBD and those with an extended hospital stay may benefit from extended VTE prophylaxis. This study demonstrates that a stratified approach may be required to reduce the incidence of VTE.
authors.affiliation: Institute for Science and Technology in Medicine, Keele University, Stoke on Trent, UK.
authors.forename: Y
authors.initials: Y
authors.lastname: El-Dhuwaib
authors.affiliation: Department of Surgery, Christie NHS Foundation Trust, Manchester, UK.
authors.forename: C
authors.initials: C
authors.lastname: Selvasekar
authors.affiliation: Department of Surgery, Mid Cheshire Hospitals NHS Foundation Trust, Crewe, UK.
authors.forename: D J
authors.initials: DJ
authors.lastname: Corless
authors.affiliation: Institute for Science and Technology in Medicine, Keele University, Stoke on Trent, UK.|Department of Surgery, Royal Stoke University Hospital, Stoke on Trent, UK.
authors.forename: M
authors.initials: M
authors.lastname: Deakin
authors.affiliation: Institute for Science and Technology in Medicine, Keele University, Stoke on Trent, UK.|Department of Surgery, Mid Cheshire Hospitals NHS Foundation Trust, Crewe, UK.
authors.forename: J P
authors.initials: JP
authors.lastname: Slavin
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003082:Colectomy / Q000009:adverse effects* / Q000379:methods; D004638:Emergency Treatment / Q000009:adverse effects / Q000379:methods; D004739:England / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D015212:Inflammatory Bowel Diseases / Q000150:complications / Q000601:surgery; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000150:complications / Q000601:surgery; D009369:Neoplasms / Q000150:complications / Q000601:surgery; D010351:Patient Discharge / Q000706:statistics & numerical data; D010359:Patient Readmission / Q000706:statistics & numerical data; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology; D011655:Pulmonary Embolism / Q000453:epidemiology* / Q000209:etiology; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D054556:Venous Thromboembolism / Q000453:epidemiology* / Q000209:etiology; D020246:Venous Thrombosis / Q000453:epidemiology* / Q000209:etiology
keywords: Colorectal resection; Hospital Episode Statistics; deep vein thrombosis; pulmonary embolism; venous thromboembolism