Blood Clot Trouble in Colorectal Surgery

Blood clots can still form after colorectal surgery despite taking preventative measures

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) There are risks associated with any type of surgery, including the risk of developing a blood clot while recovering in the hospital. Doctors may prescribe blood thinners or use special devices to help patients prevent clots, but these steps don't always ensure clots will not form.

A recent study found that blood clots occur most frequently in patients who have surgical site infections, even when measures have been taken to prevent clots.

The findings stressed the need to keep a close watch on patients after surgery and showed that clots can still happen even when doctors follow guidelines to prevent them.

"Talk to your doctor about the risks with colorectal surgery."

Researchers, led by Francesca Monn, MPH, from Indiana University School of Medicine in Indianapolis, and colleagues from Johns Hopkins University looked at the characteristics of patients who developed blood clots after having colorectal surgery.

The study included 615 adult patients found through the National Surgical Quality Improvement Program database who had the surgery between July 2009 and July 2011.

Researchers found that more than 6 percent of the patients developed a blood clot somewhere in their veins after surgery. Less than 1 percent of patients had a clot in the lungs, and another 1 percent had clots in both the lungs and the veins.

Among patients with blood clots, 92 percent had been ordered to take precautionary measures to try and prevent the clots from forming.

The odds of developing a blood clot were 4.21 times greater among patients who had an infection after an operation than those who had no infection.

"We have identified a relationship between [blood clots] and postoperative infectious complications, which might serve as an important early warning of future thrombotic events and might be used to identify patients warranting active [blood clot] surveillance," researchers wrote in their report.

More than half of the patients with blood clots developed some infectious complication, compared to only 29 percent of the patients without clots. Almost two-thirds of these infections started before or on the same day that the blood clot formed.

Because of the infections, Susan Gearhart, MD, assistant professor of colorectal surgery at Johns Hopkins Medicine and co-author of the study, said in a press release that colorectal surgery patients should be more intensely monitored after having the procedure and suggested keeping patients on blood thinners for a month after surgery.

"There should be heightened awareness about the potential for [blood clots] in patients with surgical-site infections," said Maxwell Chait, MD, a gastroenterologist with ColumbiaDoctors Medical Group and dailyRx Contributing Expert.

"This would require more intense monitoring of colorectal surgery patients who develop surgical-site infections to screen for clots in those with infections."

The authors noted that the number of people who had blood clots in their study was small. They did not know if other risk factors for blood clots contributed to its formation among patients.

The authors received funding, royalties and honoraria for contributing to various publications, lectures and testimony of a number of companies.

The study was published online January 10 in the Journal of the American College of Surgeons. Funding information for the study was not available.

Reviewed by: 
Review Date: 
January 22, 2013
Last Updated:
January 24, 2013