Can sepsis predict deep venous thrombosis in colorectal surgery?

被引:7
作者
Hatch, Quinton [1 ]
Nelson, Daniel [1 ]
Martin, Matthew [1 ]
Maykel, Justin A. [2 ]
Johnson, Eric K. [1 ]
Champagne, Bradley J. [3 ]
Hyman, Neil H. [4 ]
Steele, Scott R. [1 ]
机构
[1] Madigan Army Med Ctr, Dept Surg, Tacoma, WA 98431 USA
[2] Univ Massachusetts, Mem Med Ctr, Dept Surg, Div Colorectal Surg, Worcester, MA 01605 USA
[3] Case Med Ctr, Div Colorectal Surg, Dept Surg, Cleveland, OH USA
[4] Univ Chicago Med, Dept Surg, Chicago, IL USA
关键词
Deep venous thrombosis; Colorectal; Surgery; Sepsis; CARDIOVASCULAR RISK-FACTORS; VEIN THROMBOSIS; PULMONARY-EMBOLISM; THROMBOEMBOLISM; PROPHYLAXIS; DISEASE; COHORT; IMPACT;
D O I
10.1016/j.amjsurg.2015.06.016
中图分类号
R61 [外科手术学];
学科分类号
摘要
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.
引用
收藏
页码:53 / 58
页数:6
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