The incidence and risk factors of venous thromboembolism in Japanese inpatients with inflammatory bowel disease: a retrospective cohort study

Background/Aims Venous thromboembolism (VTE) is a major extraintestinal manifestation in inflammatory bowel disease (IBD), regarded as an independent risk factor for VTE according to reports from Western countries. However, the incidence and risk factors of VTE in Asian IBD patients are not fully understood. We aimed to reveal the incidence and risk factors of VTE in Japanese IBD inpatients. Methods The incidence of VTE in inpatients with IBD (n=340), gastrointestinal cancers (n=557), and other gastrointestinal diseases (n=569) treated at our hospital from 2009 to 2013 was retrospectively investigated. The characteristics and laboratory data of IBD inpatients with and without VTE were compared in univariate and multivariate analyses. Clinical courses of VTE in IBD were surveyed. Results VTE was detected in 7.1% of IBD inpatients, significantly higher than in gastrointestinal cancer inpatients (2.5%) and inpatients with other gastrointestinal diseases (0.88%). The incidence of VTE in ulcerative colitis (UC) patients (16.7%) was much higher than that in those with Crohn's disease (3.6%). In the univariate analysis, the risk factors were an older age, central venous catheter, prednisolone, surgery, low serum albumin, high serum C-reactive protein and D-dimer. According to a multivariate analysis, >50 years of age and surgery were the only risk factors. The in-hospital mortality rate of IBD inpatients with VTE was 4.2%. Conclusions The incidence of VTE with IBD, especially UC, was found to be high compared with other digestive disease, which was almost equivalent to that of Western countries. The efficacy of prophylaxis needs to be investigated in Asian IBD patients.

[1]  L. Mazzolai,et al.  Prevalence and risk factors for venous thromboembolic complications in the Swiss Inflammatory Bowel Disease Cohort , 2016, Scandinavian journal of gastroenterology.

[2]  A. Gasbarrini,et al.  Prevention and Treatment of Venous Thromboembolism in Patients with IBD: A Trail Still Climbing , 2015, Inflammatory bowel diseases.

[3]  O. Yuksel,et al.  Overview of Venous Thrombosis in Inflammatory Bowel Disease , 2015, Inflammatory bowel diseases.

[4]  A. Kyritsis,et al.  Cerebral sinus venous thrombosis in inflammatory bowel diseases. , 2013, QJM : monthly journal of the Association of Physicians.

[5]  M. Cottone,et al.  The Role of Portal Vein Thrombosis in the Clinical Course of Inflammatory Bowel Diseases: Report on Three Cases and Review of the Literature , 2012, Gastroenterology research and practice.

[6]  A. Stadnicki Involvement of coagulation and hemostasis in inflammatory bowel diseases. , 2012, Current vascular pharmacology.

[7]  M. Bousser,et al.  Cerebral Venous Thrombosis in Inflammatory Bowel Diseases: Eight Cases and Literature Review , 2011, International journal of stroke : official journal of the International Stroke Society.

[8]  C. Trenor,et al.  Thrombosis and inflammatory bowel disease: A call for improved awareness and prevention , 2011, Inflammatory bowel diseases.

[9]  E. Manzato,et al.  Deep Venous Thrombosis After Surgery for Inflammatory Bowel Disease: Is Standard Dose Low Molecular Weight Heparin Prophylaxis Enough? , 2010, World Journal of Surgery.

[10]  J. West,et al.  Venous thromboembolism during active disease and remission in inflammatory bowel disease: a cohort study , 2010, The Lancet.

[11]  Justina J. Sam,et al.  Rising Prevalence of Venous Thromboembolism and Its Impact on Mortality Among Hospitalized Inflammatory Bowel Disease Patients , 2008, The American Journal of Gastroenterology.

[12]  S. Danese,et al.  Inflammation and Coagulation in Inflammatory Bowel Disease: The Clot Thickens , 2007, The American Journal of Gastroenterology.

[13]  J. Heit The Epidemiology of Venous Thromboembolism in the Community: Implications for Prevention and Management , 2006, Journal of Thrombosis and Thrombolysis.

[14]  S. Kohno,et al.  Evaluation of venous thromboembolism and coagulation-fibrinolysis markers in Japanese patients with inflammatory bowel disease , 2004, Journal of Gastroenterology.

[15]  W. Reinisch,et al.  Is inflammatory bowel disease an independent and disease specific risk factor for thromboembolism? , 2004, Gut.

[16]  A. Fichera,et al.  Superior Mesenteric Vein Thrombosis After Colectomy for Inflammatory Bowel Disease , 2003, Diseases of the colon and rectum.

[17]  D. Einstein,et al.  CT depiction of portal vein thrombi after creation of ileal pouch-anal anastomosis. , 2003, Radiology.

[18]  K. Zimmer,et al.  Coagulation and fibrinolysis in children, adolescents, and young adults with inflammatory bowel disease. , 1999, Journal of pediatric gastroenterology and nutrition.

[19]  I. Brandslund,et al.  Markers of Coagulation and Fibrinolysis as Measures of Disease Activity in Inflammatory Bowel Disease , 1998 .

[20]  R. Abbate,et al.  Hemostatic abnormalities in inflammatory bowel disease. , 1996, Thrombosis research.

[21]  M. Webberley,et al.  Thromboembolism in inflammatory bowel disease: role of platelets. , 1993, Gut.

[22]  R. Beart,et al.  Vascular complications of inflammatory bowel disease. , 1986, Mayo Clinic proceedings.

[23]  R. Gage,et al.  Life histories of patients with chronic ulcerative colitis: a review of 2,000 cases. , 1968, Gastroenterology.

[24]  Sloan Wp,et al.  Life histories of patients with chronic ulcerative colitis: a review of 2,000 cases. , 1950 .