Occurrence of an infectious complication may be a predictor of venous thromboembolism after surgery for colorectal cancer

TL;DR

The study found that patients who had an infectious complication after colorectal cancer surgery were more likely to develop a dangerous blood clot.

Contribution

Identified infectious complications as a novel independent predictor of venous thromboembolism after colorectal cancer surgery.

Findings

1.0% of patients developed venous thromboembolism (VTE) after colorectal cancer surgery.

Infectious complications were an independent predictor of VTE (odds ratio 7.95).

VTE patients had significantly more other postoperative complications (84.6% vs 28.5%).

Abstract

Venous thromboembolism (VTE) is a rare complication after colorectal cancer surgery, but may have a devastating outcome. The goal of this study was to report the incidence of VTE in our practice and identify predictors of VTE after colorectal resection for cancer.

This was a single-center retrospective cohort analysis. We used the hospital-specific Dutch Colorectal Audit database to identify patients that underwent oncologic colorectal resection between 2015 and 2022 and subsequently developed a VTE. Patients who used therapeutic anticoagulants postoperatively due to pre-existing conditions were excluded. During the study period, VTE prophylaxis was applied according to the local protocol. Patient characteristics and postoperative data were extracted from the patient records.

Overall, 1261 patients were included, of which 13 patients developed VTE (1.0%). All cases involved pulmonary embolism. One patient (7.7%) had a simultaneous deep venous thrombosis. There were no deaths due to VTE. The incidence of other complications was significantly higher in patients with VTE (84.6% vs 28.5%; P ≤ .001). Multivariable logistic regression analysis indicated that the occurrence of an infectious complication was an independent predictor of VTE (odds ratio, 7.95; 95% CI, 2.20-28.69). Other variables that have previously been connected to the occurrence of VTE have been analyzed, but no other independent predictors were identified.

An infectious complication may be an independent predictor of the development of VTE. The necessity of prolonged prophylaxis after oncologic colorectal resections remains unclear.

•Venous thromboembolism (VTE) is a rare but severe complication after colorectal surgery.•Patients with and without a VTE after colorectal cancer surgery were compared.•In the VTE group, other complications occurred significantly more often.•In this cohort, an infectious complication was an independent predictor of VTE.

Venous thromboembolism (VTE) is a rare but severe complication after colorectal surgery.

Patients with and without a VTE after colorectal cancer surgery were compared.

In the VTE group, other complications occurred significantly more often.

In this cohort, an infectious complication was an independent predictor of VTE.

Figures