P160 Hypercoagulability in patients undergoing abdominopelvic surgery for inflammatory bowel disease: insights from thromboelastography
S. Holubar*1, C. H. A. Lee1, A. Feinberg1, O. Lavryk1, L. Stocchi1, F. Rieder2, M. Regeuiro2, T. Hull1, S. Steele1
1Cleveland Clinic, Colon and Rectal Surgery, Cleveland, USA, 2Cleveland Clinic, Gastroenterology, Hepatology, and Nutrition, Cleveland, USA
Hypercoagulability in patients with inflammatory bowel disease (IBD) is a haematological extra-intestinal manifestation thought to be driven by the gut inflammatory response. However, mechanisms driving the coagulation abnormalities are poorly understood. The aim of this pilot study is to characterise coagulation profiles in IBD surgical patients using thromboelastography (TEG).
A single-surgeon retrospective study was performed after IRB approval. Consecutive patients with Crohn’s disease (CD) or ulcerative colitis (UC) who underwent bowel surgery from June to September 2018 were included. All patients (100%) received perioperative VTE chemoprophylaxis. Hypercoagulability profile based on TEG results was defined by any combination of: (1) low R-value, (2) high-degree angle, (3) high maximum amplitude (MA), (4) elevated coagulation index. Short-term (30-day) surgical outcomes were reported. Figures represent frequency (proportion) or median (range).
A total of 19 IBD patients had a TEG prior to surgery. The age was 33 (23–70), more were women (63%,
We observed that the majority of surgical IBD patients have a hypercoagulable TEG profile, and patients with evidence of hypercoagulability on thromboelastography may be at increased risk of post-operative VTE. Our data suggest, given the multi-factorial nature of hypercoagubility in these patients, which novel VTE chemoprophylaxis approaches are needed.