Faculty Collaboration Database

The incidence of venous thromboembolism in children following colorectal resection for inflammatory bowel disease: A multi-center study. J Pediatr Surg 2020 Nov;55(11):2387-2392

Date

03/09/2020

Pubmed ID

32145975

DOI

10.1016/j.jpedsurg.2020.02.020

Scopus ID

2-s2.0-85080996189 (requires institutional sign-in at Scopus site)   7 Citations

Abstract

BACKGROUND/PURPOSE: Children with inflammatory bowel disease (IBD) have increased risk for venous thromboembolism (VTE). We sought to determine incidence and risk factors for postoperative VTE in a multicenter cohort of pediatric patients undergoing colorectal resection for IBD.

METHODS: Retrospective review of children ≤18 years who underwent colorectal resection for IBD from 2010 to 2016 was performed at four children's hospitals. Primary outcome was VTE that occurred between surgery and last follow-up. Factors associated with VTE were determined using univariable and multivariable analyses.

RESULTS: Two hundred seventy-six patients were included with median age 15 years [13,17]. Forty-two children (15%) received perioperative VTE chemoprophylaxis, and 88 (32%) received mechanical prophylaxis. DVT occurred in 12 patients (4.3%) at a median of 14 days postoperatively [8,147]. Most were portomesenteric (n = 9, 75%) with the remaining catheter-associated DVTs in extremities (n = 3, 25%). There was no association with chemoprophylaxis (p > 0.99). On Cox regression, emergent procedure [HR 18.8, 95%CI: 3.18-111], perioperative plasma transfusion [HR 25.1, 95%CI: 2.4-259], and postoperative infectious complication [HR 10.5, 95%CI: 2.63-41.8] remained predictive of DVT.

CONCLUSION: Less than 5% of pediatric IBD patients developed postoperative VTE. Chemoprophylaxis was not protective but rarely used. Patients with risk factors identified in this study should be monitored or given prophylaxis for VTE.

LEVEL OF EVIDENCE: Treatment Study, Level III.

Author List

Bence CM, Traynor MD Jr, Polites SF, Ha D, Muenks P, St Peter SD, Landman MP, Densmore JC, Potter DD Jr

Author

John C. Densmore MD Professor in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adolescent
Blood Component Transfusion
Child
Humans
Incidence
Inflammatory Bowel Diseases
Plasma
Postoperative Complications
Proctocolectomy, Restorative
Retrospective Studies
Risk Factors
Venous Thromboembolism