Can sepsis predict deep venous thrombosis in colorectal surgery?

Am J Surg. 2016 Jan;211(1):53-8. doi: 10.1016/j.amjsurg.2015.06.016. Epub 2015 Aug 12.

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.

Keywords: Colorectal; Deep venous thrombosis; Sepsis; Surgery.

Publication types

  • Evaluation Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Colectomy*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Perioperative Period
  • Postoperative Complications / etiology*
  • Propensity Score
  • Rectum / surgery*
  • Retrospective Studies
  • Risk Factors
  • Sepsis / complications*
  • Venous Thrombosis / etiology*
  • Young Adult