Mustafa Al-Jubouri, MD, MRCSI, Mohanad Baldawi, MD, Mustafa Baldawi, MD, Munier Nazzal, MD, FACS, Francis Burnicardi, MD, FACS. University of Toledo
Introduction: The prevalence of colonic diverticular disease increases with age and reaches over 70% in octogenarians. Dietary modification and the use of antibiotics are the main form of management of uncomplicated acute diverticulitis. But for complicated cases, surgical intervention is required.
Major surgery is a significant risk factor for venous thromboembolism. The incidence and risk factors of venous thromboembolism in patients undergoing colonic surgery for complicated diverticulitis has not been studied.
This study aims to determine the risk factors and the incidence of postoperative venous thromboembolism (VTE) within a 30 day postoperative period, in patients with complicated diverticulitis requiring surgical intervention.
Methods: Retrospective review from the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP). All patients who underwent colonic resection for complicated acute diverticulitis from the years 2012-2016 were included in our analysis.
Data regarding patient demographics, comorbidities, type of operative intervention and occurrence of postoperative VTE was recorded
Results: A total of 47,890 patients underwent colorectal resection for complicated acute diverticulitis during the years 2012-2016. The incidence of VTE was 1.6% (n=774) within 30 days postoperatively.
Univariate analysis showed an increased risk of VTE with increasing age, African-American race, diabetes mellitus, congestive heart failure, COPD, hypertension, chronic steroid use, emergent surgery, open surgery, preoperative sepsis, preoperative blood transfusion, impaired renal function, and intraoperative blood transfusion. Multivariate analysis identified 9 independent predictors of postoperative VTE: age >70 years, chronic steroid use, emergent surgery, open surgery, preoperative PRBC transfusion, preoperative sepsis, BUN >20 mg/dl, hematocrit <36 and intraoperative blood transfusion.
Conclusion: Multiple risk factors are associated with higher risk VTE among patients with complicated acute diverticulitis undergoing colorectal resection. Awareness of these factors can help the colorectal or general surgeons predict patients at high risk of developing VTE and therefore, modify and be more vigilant in their prophylaxis measures.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 91669
Program Number: P038
Presentation Session: Poster Session (Non CME)
Presentation Type: Poster