TOPLINE:

Patients with inflammatory bowel disease (IBD) who underwent colorectal cancer (CRC) surgery had a higher risk for venous thromboembolism (VTE) within a year than those without IBD, with the risk being especially elevated in those aged 60-69 years and in those with active IBD within the first 30 days post-surgery.

METHODOLOGY:

• VTE risk is higher in patients with IBD than in the general population, as well as in those with IBD undergoing surgery, but prior comparative studies did not focus specifically on CRC surgery.
• Using Danish health registries (1996-2021), researchers conducted a population-based cohort study to compare VTE risk in patients with and without IBD who underwent CRC surgery.
• Patients with IBD were stratified by medical treatment received within 120 days before or on the date of CRC surgery.
• The primary outcome was registry-recorded VTE diagnosis (deep vein thrombosis and pulmonary embolism) after surgery.

TAKEAWAY:

• Among 83,950 patients who underwent their first CRC surgery, 661 had IBD (472 with ulcerative colitis, 176 with Crohn’s disease, and 13 with unclassified IBD). During follow-up, 31 patients with IBD and 2153 patients without IBD developed VTE.
• VTE risk within 30 days was 1.5% in patients with IBD vs 0.7% in those without IBD; within 0-90 days, 2.1% vs 1.3%, respectively; and within 0-365 days, 4.7% vs 2.6%, respectively.
• From 91 to 365 days, VTE risk remained higher (adjusted hazard ratio [aHR], 1.74). Within 30 days, the highest risks were observed among men (aHR, 2.26), patients aged 60-69 years (aHR, 4.63), and those with active disease IBD (aHR, 5.29).
• Ulcerative colitis had the strongest association with VTE risk, particularly within 30 days post-surgery; risk was also notably higher in distal CRC (aHR, 4.00).

IN PRACTICE:

“These findings emphasize the need for increased awareness of VTE risk in high-risk IBD patients and underscore the importance of optimizing disease control to reduce VTE risk in those undergoing CRC surgery,” the authors of the study wrote.

SOURCE:

The study was led by Gencer Kurt, MD, Department of Clinical Epidemiology and Center for Population Medicine, Aarhus University Hospital and Aarhus University in Aarhus, Denmark. It was published online in The American Journal of Gastroenterology.

LIMITATIONS:

The small number of VTE events in the IBD group, particularly in Crohn’s disease, may have led to imprecise estimates. Clinical remission vs active disease could not be distinguished owing to overlapping treatment indicators. Proxies such as hospitalization and corticosteroid use may not capture mild disease activity.

DISCLOSURES:

The study did not receive any specific funding. The authors declared having no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.