Clinical ScienceCan sepsis predict deep venous thrombosis in colorectal surgery?

- The overall rate of DVT in colorectal surgery patients was low at 1.7%.
- All septic complications had independent associations with increased DVT rates.
- The most significant infectious contributor to higher DVT rates was pneumosepsis.
- Sepsis predicts higher DVT rates in colorectal surgery patients.

BackgroundLittle data exist regarding the impact of sepsis on deep venous thrombosis (DVT) in colorectal surgery patients. We sought to elucidate this relationship.MethodsCurrent 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.ResultsOf 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).ConclusionPerioperative sepsis is a significant risk factor for postoperative DVT in the colorectal surgery population.