Clostridium difficile increases the risk for venous thromboembolism

Barmparas, Galinos; Fierro, Nicole M; Lamb, Alexander W.; Lee, Debora; Nguyen, Brandon; Tran, Daniel H.; Chung, Rex; Ley, Eric J.

doi:10.1016/j.amjsurg.2014.05.025

Cited by 15 publications

(9 citation statements)

References 28 publications

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“…There have been reports of increased incidence of venous thromboembolic episodes (VTE) in patients with Clostridium difficile infections [9][10][11]. According to one study, it was found that patients with a positive Clostridium difficile testing were more likely to have associated VTE (OR of 3.23 (95% CI 1.00, 10.45).…”

Section: Discussionmentioning

confidence: 99%

“…According to one study, it was found that patients with a positive Clostridium difficile testing were more likely to have associated VTE (OR of 3.23 (95% CI 1.00, 10.45). It was concluded in the study that the direct causation of the Clostridium difficile infection with VTE seemed less likely, but more so due to prolonged immobilization due to increased lengths of stay [ 10 ]. A surgical cohort study that included 1728 surgical patients over a course of 30 months showed an independent association of VTE with Clostridium difficile (OR: 1.87 [1.00 to 3.47], P = .049) [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

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A Rare Case of Arterial and Venous Thromboembolism in a Patient With Severe Clostridium difficile Infection

Kumar¹,

Ghazanfar²,

Davidson³

2021

Cureus

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Most cases of Clostridium difficile infection are hospital acquired; but in recent times, the incidence of community-acquired infections has increased. Patients with Clostridium difficile infections are at an increased risk for thrombosis. We report a case of an 82-year-old female who was admitted to the intensive care unit for acute hypoxic respiratory failure and septic shock. She was found to have Clostridium difficile infection at presentation. During the hospitalization, we discovered bilateral lower extremity venous thromboembolism, bilateral pulmonary embolism, multifocal thromboembolic brain infarctions, and acute arterial thromboembolic occlusion of right upper and lower extremities. This patient adds to the list of cases of venous thromboembolism associated with Clostridium difficile infections and is the first case of associated arterial embolic phenomenon. There is a need to further investigate the association of Clostridium difficile infections and thromboembolism.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A Rare Case of Arterial and Venous Thromboembolism in a Patient With Severe Clostridium difficile Infection

Kumar¹,

Ghazanfar²,

Davidson³

2021

Cureus

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“…Interestingly, 87% of the patients in this study also had additional risk factors for VTE including hospitalization, immobilization, malignancy or recent surgery: all factors common in the perioperative IBD patient population [ 95 ]. Another study found that C. difficile increased the rate of VTE among IBD patients [ 96 ]. While there are no established guidelines for VTE prophylaxis in IBD patients undergoing surgery, the aforementioned risk factors are common among surgical patients, highlighting the need for aggressive prophylaxis in this patient population.…”

Section: Aminosalicylatesmentioning

confidence: 99%

Perioperative use of immunosuppressive medications in patients with Crohn's disease in the new "biological era"

Lightner

Shen

2017

Gastroenterology Report

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Crohn’s disease (CD) is characterized by transmural inflammation of the gastrointestinal tract leading to inflammatory, stricturing and/or and fistulizing disease. Once a patient develops medically refractory disease, mechanical obstruction, fistulizing disease or perforation, surgery is indicated. Unfortunately, surgery is not curative in most cases, underscoring the importance of bowel preservation and adequate perioperative medical management. As many of the medications used to treat CD are immunosuppressive, the concern for postoperative infectious complications and anastomotic healing are particularly concerning; these concerns have to be balanced with preventing and treating residual or recurrent disease. We herein review the available literature and make recommendations regarding the preoperative, perioperative and postoperative administration of immunosuppressive medications in the current era of biological therapy for CD. Standardized algorithms for perioperative medical management would greatly assist future research for optimizing surgical outcomes and preventing disease recurrence in the future.

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“…It is well-known that the pathogenesis of venous thromboembolism (VTE) involves the Virchow's triad: stasis, endothelial injury, and hypercoagulability. Various studies have shown an increased rate of VTE in patients with CDI, likely secondary to the formation of a proinflammatory state [3,4]. However, data is scarce regarding the impact of CDI on outcomes of VTE hospitalizations.…”

Section: Introductionmentioning

confidence: 99%

Correction

Jhaveri¹,

Som²,

Padala³

et al. 2020

Cureus

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Background Clostridium difficile infection (CDI) is associated with high mortality. Studies have shown an increased rate of venous thromboembolism (VTE) in patients with CDI. However, literature regarding the impact of CDI on outcomes of VTE-related hospitalizations is scarce. Our study aimed to assess the impact of CDI on inhospital outcomes among VTE hospitalizations. Methods The 2016 National Inpatient Sample (NIS) was used to identify all adult hospitalizations in the United States with a primary discharge diagnosis of acute VTE. Hospitalizations with deep vein thrombosis (DVT) or pulmonary embolism (PE) were included under VTE. The sample was stratified based on the presence or absence of active CDI. Chi-square test and weighted Student's t-test were used to analyze categorical and continuous variables, respectively. The adjusted odds ratio (OR) for clinical outcomes were calculated using multivariate logistic regression analysis. Subgroup analyses for DVT and PE hospitalizations were performed. All analyses were completed in SAS (SAS Institute Inc., Cary, NC), and a p-value of <0.05 was considered statistically significant. Results We identified 382,585 weighted hospitalizations for VTE. Among them, 0.8% had concomitant CDI. The presence of CDI was associated with a statistically significant increase in in-hospital mortality (6% vs. 3%), hospitalization cost ($147,356.5 vs. $55,193), and length of stay (13.7 vs. 5.4 days). There were more incidents of bleeding and acute respiratory failure requiring prolonged ventilation in patients with CDI. The odds of stroke were significantly higher in patients with CDI and DVT. Conclusion CDI independently increased in-hospital mortality in VTE. Preventing CDI in the VTE population may mitigate complications, improve in-hospital outcomes, and reduce treatment costs.

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Clostridium difficile increases the risk for venous thromboembolism

Cited by 15 publications

References 28 publications

A Rare Case of Arterial and Venous Thromboembolism in a Patient With Severe Clostridium difficile Infection

A Rare Case of Arterial and Venous Thromboembolism in a Patient With Severe Clostridium difficile Infection

Perioperative use of immunosuppressive medications in patients with Crohn's disease in the new "biological era"

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