Incidence and Risk Factors of Postoperative Venous Thromboembolism in Patients Undergoing Colorectal Cancer Surgery: A Prospective Cross-Sectional Study

Background: Among the most prevalent malignant neoplasms worldwide, colorectal cancer (CRC) is a major threat to human life and health. The second most common cause of death for cancer patients receiving medical and surgical treatment is venous thromboembolism (VTE). Patients with colorectal cancer who have radical surgery run the risk of developing venous thromboembolism (VTE). The current study analyzes the incidence and risk factors associated with post-operative VTE after colorectal cancer surgery(CRC) within 90 days of postoperative period.

Methods and Materials: This was a prospective cross sectional study conducted in a tertiary medical college and hospital of Dhaka, Bangladesh from January 2021 to December 2023.There was no VTE prophylaxis guideline in the institute. None of the patient received any standard VTE prophylaxis in the perioperative period. Statistical analysis was performed using IBM SPSS version 26.0. Statistical significance was defined as a p-value of < 0.05. Multivariable analysis using a binary logistic regression model was used to verify the independent risk factors for VTE in the post-operative patients. Variables identified as having a potential association (p < 0.05) in a univariate analysis were entered into each multivariable analysis model.

Results: A total of 86 patients who underwent surgery for CRC were included in the study. The included patients were divided into two groups: VTE and non-VTE group. Out of 86 patients, 7(8.13%) patients presented with DVT. Two patients (2.3%) had pulmonary embolism and both of them died in the post-operative period. Advanced age (OR-1.876 95% CI: 1.765–1.975) elevated Caprini score (OR-1.564, 95%CI: 0.85-1.72), elevated d-dimer (OR-1.446,95% CI: 1.130-0.1.849), advanced stage of disease (OR-1.94, 95% CI: 1.87-1.213), prolong duration of surgery OR-1.277,95% CI;0.87-1.312) and presence of inflammatory bowel disease(OR-1.34,95% CI:1.29-1.41) were independent predictors of postoperative VTE (P<0.05).

Conclusion: The current study showed post-operative VTE is a grave complication after malignant colorectal surgery. There were several factors for development of post-operative VTE in CRC patients. So further large scale multicenter study should be conducted to identify the predictors of post-surgical VTE.