Steroid Use, Presence of Central Venous Catheter Predict VTE Risk in Children With IBD

Risk factors for venous thromboembolism (VTE) in children with inflammatory bowel disease (IBD) include steroid use and the presence of a central venous catheter, according to a study in the Journal of Pediatric Gastroenterology and Nutrition.

This case-controlled study included 23 hospitalized children with IBD who were diagnosed with VTE at a large referral center. Researchers compared these patients with another group of children with IBD but no presence of VTE (n=111). The 2 groups were hospitalized for IBD between 2008 and 2018. By comparing the 2 groups over this 10-year follow-up period, the investigators examined the clinical characteristics of patients and identified risk factors for VTE.

Overall, the median age at VTE diagnosis in this population was 17 years, while median duration from IBD diagnosis to VTE diagnosis was 2.3 months. The median duration of anticoagulation treatment was 3.8 months. No major bleeding events were reported in patients treated with anticoagulation.

In the 23 cases with IBD and VTE, independent risk factors of VTE included the presence of a central venous catheter (odds ratio [OR], 77.7; 95% CI, 6.86–880.6; P <.001) and steroid use (OR, 12.7; 95% CI, 1.28–126.4; P =.03).

Independent risk factors for clot, according to a multivariable analysis, also included the presence of a central venous catheter (OR, 42.4; 95% CI, 6.8–265.8; P <.001) and steroid use (OR, 7.5; 95% CI, 1.5–38.2; P =.02). The significance of these 2 risk factors persisted when the investigators controlled for IBD subtype, disease activity, and exposure to infliximab.

Limitations of this study included its single-center design as well as the small sample size of cases with IBD and VTE.

Given the findings from this study, the investigators suggest, “Pharmacologic thromboprophylaxis should be considered in children and adolescents with IBD based on risk stratification.”

Reference

Mitchel EB, Rosenbaum S, Gaeta C, et al. Venous thromboembolism in pediatric inflammatory bowel disease: a case-control study. J Pediatr Gastroenterol Nutr. 2021;72(5):742-747. doi: 10.1097/MPG.0000000000003078