Quinton Hatch1, Daniel Nelson2, Matthew Martin2, Justin A Maykel3, Eric K Johnson2, Bradley J Champagne4, Neil H Hyman5, Scott R Steele2. 1. Department of Surgery, Madigan Army Medical Center, 9040 Jackson Avenue, Tacoma, WA 98431, USA. Electronic address: qhatch@gmail.com. 2. Department of Surgery, Madigan Army Medical Center, 9040 Jackson Avenue, Tacoma, WA 98431, USA. 3. Division of Colorectal Surgery, Department of Surgery, University of Massachusetts Memorial Medical Center, Worcester, MA, USA. 4. Division of Colorectal Surgery, Department of Surgery, Case Medical Center, Cleveland, OH, USA. 5. Department of Surgery, University of Chicago Medicine, Chicago, IL, USA.
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). CONCLUSION: Perioperative sepsis is a significant risk factor for postoperative DVT in the colorectal surgery population. Published by Elsevier Inc.
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). CONCLUSION: Perioperative sepsis is a significant risk factor for postoperative DVT in the colorectal surgery population. Published by Elsevier Inc.
Entities:
Keywords:
Colorectal; Deep venous thrombosis; Sepsis; Surgery