ArticleClinical epidemiology2026
Venous Thromboembolism After Total Colectomy in Inflammatory Bowel Disease: Risk Factors and Mortality - a Danish Population-Based Cohort Study.
Article in Clinical epidemiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Purpose: Total colectomy is a key intervention in inflammatory bowel disease (IBD) management and a high-risk procedure for postoperative venous thromboembolism (VTE). We investigated risk factors for postoperative VTE and VTE-associated mortality in patients with IBD undergoing total colectomy. Patients and Methods: We conducted a population-based cohort study using Danish registries (1996-2021), including all patients with IBD who underwent total colectomy (n=5303). We calculated the 90-day cumulative risk of VTE and used Cox regression to assess the association between potential risk factors and VTE. We used the Kaplan-Meier method to calculate 1-year mortality after VTE, and we compared mortality between patients with and without VTE using Cox regression as an estimate of the mortality rate ratio. Results: The 30-day VTE risk was 0.6% in patients with Crohn's disease and 1.3% in those with ulcerative colitis. During this period, the strongest risk factors were age (adjusted hazard ratio 3.95 [95% CI 1.87-8.37]) for 41-60 years and 2.96 [1.30-6.75] for ≥60 years vs ≤40 years), calendar year of total colectomy (3.84 [1.10-13.34] for 2014-2020 vs 1996-2001), high comorbidity burden (2.14 [0.94-4.88] vs low comorbidity), IBD duration <1 year (1.84 [0.81-4.16] vs 1-5 years), male sex (1.56 ([0.92-2.64]), and corticosteroid use (1.55 [0.86-2.79]). In secondary analyses, comparing preoperative systemic corticosteroid use to non-use, we found a twofold higher 30-day VTE rate. Most associations persisted for 31-90 days, though with some attenuation. The 1-year mortality risk after VTE was 21.0% (hazard ratio of 7.65 [95% CI, 3.12-18.73]). Conclusion: Several patient and clinical factors were associated with elevated postoperative VTE risk, and VTE after total colectomy carried a substantially increased 1-year mortality. These findings may help identify high-risk subgroups and inform future studies of extended thromboprophylaxis and perioperative management in IBD.
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