Key result
Complicated appendicitis linked to ~11.5-fold higher risk of postoperative DVT/PE vs. simple appendicitis.
Why the study?
There is a paucity of data on the incidence of perioperative deep venous thrombosis and pulmonary embolism in patients undergoing surgery for non-malignant digestive diseases such as acute appendicitis.
Observational (n=536)
No
Complicated appendicitis was associated with higher postoperative VTE/PE risk; hypothesis-generating and should not yet change prophylaxis practice.
BACKGROUND: Cancer is a risk factor for perioperative deep venous thrombosis and pulmonary embolism (DVT/PE). However, there is a paucity of data on non-malignant digestive diseases. In this study, we aimed to investigate the incidence of DVT/PE among patients, following surgery for acute appendicitis and other digestive diseases. METHODS: We retrospectively reviewed the records of patients who underwent surgical procedures involving the digestive system between April 2018 and March 2019 attended by anesthesiologists (n = 536). RESULTS: DVT/PE developed in seven patients (7/77, 9.1%, 95% confidence interval [CI] 3.7-17.8%) after surgery for acute appendicitis, and in six patients (6/83, 7.2%, 95%CI 2.7-15.1%) after elective surgery for colorectal cancer. Among the acute appendicitis group, six patients (6/30 20.0%) with complicated appendicitis (gangrenous or perforated appendicitis), and one patient (1/47 2.1%) with simple appendicitis showed postoperative DVT/PE. Patients with complicated appendicitis had a higher risk of DVT/PE than those with simple appendicitis with an odds ratio of 11.5 (95%CI 1.3-101.1). CONCLUSIONS: Although patients with acute appendicitis lack three of the risk factors for DVT/PE (cancer, long operative time, and older age), their 95% CI for the incidence of DVT/PE was comparable to that of patients undergoing elective surgery for colorectal cancer. Therefore, caution must be exercised during the perioperative period for preventing DVT/PE.
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Otsuka et al. (2020) conducted an observational in Digestive diseases requiring surgery (including acute appendicitis) (n=536). Complicated appendicitis vs. Simple appendicitis was evaluated on Incidence of postoperative deep venous thrombosis and pulmonary embolism (DVT/PE) (OR 11.5, 95% CI 1.3-101.1). Patients with complicated appendicitis had a significantly higher risk of postoperative deep venous thrombosis and pulmonary embolism compared to those with simple appendicitis (OR 11.5).
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