Inflammatory Bowel Disease Is an Independent Risk Factor for Post-Discharge VTE

deep vein thrombosis
DVT, deep vein thrombosis, thromboembolism
An inflammatory bowel disease diagnosis conferred an increased risk for venous thromboembolism; however, in surgical patients, ulcerative colitis but not Crohn disease was responsible for the elevated risk.

Inflammatory bowel disease (IBD) is an independent risk factor for post-discharge venous thromboembolism (VTE), particularly in nonsurgical patients with IBD and surgical patients with ulcerative colitis (UC), according to population-based cohort study results published in Inflammatory Bowel Disease.

In order to track rates of VTE in patients with IBD, 81,900 patients were included from the Ontario Health Administration Database in Canada. All patients were hospitalized >72 hours between 2002 and 2016. A total of 62,848 of these patients did not have surgery and 19,052 had surgery during their hospital visit. All patients were matched with non-IBD controls (n=314,240 nonsurgical and n=57,724 surgical cohorts). Each cohort and their control group were balanced for age, sex, and medical history.

A total of 12 months after discharge from the hospital, 2.3% of the nonsurgical IBE cohort and 1.6% of the surgical IBE cohort had an incidence of VTE. Within the nonsurgical cohort, the rate of VTE increased by 4% per year (incidence rate ratio, 1.04; 95% CI, 1.02-1.05). Compared with controls, at 1 month after discharge nonsurgical patients had a higher hazard ratio (HR, 1.72; 95% CI, 1.51-1.96) than the surgical cohort with UC (HR, 1.68; 95% CI, 1.16-2.45). This trend was not observed in the surgical cohort who had Crohn disease (HR, 1.07; 95% CI, 0.78-1.47).

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A study limitation is that potential confounding factors were not considered. The statistical analyses were unable to account for known VTE risk factors such as smoking, obesity, or prescribed medications.

In total, patients with UC had a 1.7-fold increased rate of VTE after a hospitalization as compared with patients without IBD. This risk was observed regardless of whether or not the patient had an operation. The investigators asserted the need for increased vigilance for signs of thromboprophylaxis in patients with UC even after they are released from hospital care.

Disclosure: Several study authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.

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McCurdy JD, Kuenzig ME, Smith G, et al. Risk of venous thromboembolism after hospital discharge in patients with inflammatory bowel disease: a population-based study [published online January 29, 2020]. Inflamm Bowel Dis. doi:10.1093/ibd/izaa002