| アブストラクト | BACKGROUND: Guidelines recommend extended thromboprophylaxis following colectomy for malignant disease, but not for non-malignant disease. The aim of this study was to determine absolute and relative rates of venous thromboembolism (VTE) following colectomy by indication, admission type and time after surgery. METHODS: A cohort study of patients undergoing colectomy in England was undertaken using linked primary (Clinical Practice Research Datalink) and secondary (Hospital Episode Statistics) care data (2001-2011). Crude rates and adjusted hazard ratios (HRs) were calculated for the risk of first VTE following colectomy using Cox regression analysis. RESULTS: Some 12,388 patients were identified; 312 (2.5 per cent) developed VTE after surgery, giving a rate of 29.59 (95 per cent c.i. 26.48 to 33.06) per 1000 person-years in the first year after surgery. Overall rates were 2.2-fold higher (adjusted HR 2.23, 95 per cent c.i. 1.76 to 2.50) for emergency compared with elective admissions (39.44 versus 25.78 per 1000 person-years respectively). Rates of VTE were 2.8-fold higher in patients with malignant disease versus those with non-malignant disease (adjusted HR 2.84, 2.04 to 3.94). The rate of VTE was highest in the first month after emergency surgery, and declined from 121.68 per 1000 person-years in the first month to 25.65 per 1000 person-years during the rest of the follow-up interval. Crude rates of VTE were similar for malignant and non-malignant disease (114.76 versus 120.98 per 1000 person-years respectively) during the first month after emergency surgery. CONCLUSION: Patients undergoing emergency colectomy for non-malignant disease have a similar risk of VTE as patients with malignant disease in the first month after surgery. |
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| ジャーナル名 | The British journal of surgery |
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| 投稿日 | 2015/9/22 |
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| 投稿者 | Humes, D J; Walker, A J; Blackwell, J; Hunt, B J; West, J |
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| 組織名 | Division of Epidemiology and Public Health, School of Medicine, University of;Nottingham, Nottingham, UK.;National Institute for Health Research Nottingham Digestive Disease Biomedical;Research Unit, Nottingham University Hospitals NHS Trust and University of;Thrombosis and Haemophilia Centre, Guy's and St Thomas' NHS Foundation Trust, St;Thomas' Hospital, London, UK. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/26387670/ |
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