Background Given the conﬂicting nature of reported risk factors for post-discharge venous thromboembolism (VTE) and unclear guidelines for post-discharge pharmacoprophylaxis, we sought to determine risk factors for 30-day post- discharge VTE after colectomy to predict which patients will beneﬁt from post-discharge pharmacoprophylaxis. Methods Patients who underwent colectomy in the American College of Surgeons National Surgical Quality Improvement Project Participant Use Files from 2011 to 2015 were identiﬁed. Logistic regression modeling was used. Receiver-operating characteristic curves were used and the best cut-points were determined using Youden’s J index (sensitivity ? speciﬁcity - 1). Hosmer–Lemeshow goodness-of-ﬁt test was used to test model calibration. A random sample of 30% of the cohort was used as a validation set. Results Among 77,823 cases, the overall incidence of VTE after colectomy was 1.9%, with 0.7% of VTE events occurring in the post-discharge setting. Factors associated with post-discharge VTE risk including body mass index, preoperative albumin, operation time, hospital length of stay, race, smoking status, inﬂammatory bowel disease, return to the operating room and postoperative ileus were included in logistic regression equation model. The model demonstrated good calibration (goodness of ﬁt P = 0.7137) and good discrimination (area under the curve (AUC) = 0.68; validation
World Journal of Surgery – Springer Journals
Published: Jan 4, 2018
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