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Invited Critique
Feb 2012

Use of National Surgical Quality Improvement Program Outcomes Data to Change Guidelines: A Sound Idea?Comment on “Increased Risk of Postoperative Deep Vein Thrombosis and Pulmonary Embolism in Patients With Inflammatory Bowel Disease”

Author Affiliations

Author Affiliations: Department of Surgery, Methodist Hospital (Drs White and Hassoun) and Methodist DeBakey Heart and Vascular Center (Dr Hassoun), Houston, Texas.

Arch Surg. 2012;147(2):124. doi:10.1001/archsurg.2011.1036

Merrill and Millham1 provide compelling data to associate patients with inflammatory bowel disease (IBD) with an increased postoperative risk for deep venous thrombosis (DVT) and pulmonary embolism. Using National Surgical Quality Improvement Program (NSQIP) data, the results likely confirm what many physicians who treat patients with IBD already believe. Current guidelines from the American College of Chest Physicians 2008 Conference on Antithrombotic and Thrombolytic Therapy name IBD as a risk factor for DVT, and surgical patients with IBD have more stringent DVT prophylaxis recommendations.2 Merrill and Millham urge reconsideration of DVT and pulmonary embolism prophylaxis for these patients.

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