Hospitalized ulcerative colitis patients have an elevated risk of thromboembolic events

Abstract

AIM:To compare thromboembolism rates between hospitalized patients with a diagnosis of ulcerative colitis and other hospitalized patients at high risk for thromboembolism. To compare thromboembolism rates between patients with ulcerative colitis undergoing a colorectal operation and other patients undergoing colorectal operations. METHODS:Data from the National Hospital Discharge Survey was used to compare thromboembolism rates between (1) hospitalized patients with a discharge diagnosis of ulcerative colitis and those with diverticulitis or acute respiratory failure, and (2) hospitalized patients with a discharge diagnosis of ulcerative colitis who underwent colectomy and those with diverticulitis or colorectal cancer who underwent colorectal operations. RESULTS:Patients diagnosed with ulcerative colitis had similar or higher rates of combined venous thromboembolism (2.03%) than their counterparts with diverticulitis (0.76%) or respiratory failure (1.99%), despite the overall greater prevalence of thromboembolic risk factors in the latter groups. Discharged patients with colitis that were treated surgically did not have significantly different rates of venous or arterial thromboembolism than those with surgery for diverticulitis or colorectal cancer. CONCLUSION:Patients with ulcerative colitis who do not undergo an operation during their hospitalization have similar or higher rates of thromboembolism than other medical patients who are considered to be high risk for thromboembolism.

The use of pharmacological prophylaxis against venous thromboembolism in hospitalised patients with severe active ulcerative colitis

“…Our VTE incidence of 5.3% (95% CI, 3.4–8.2%) is higher than the incidence of 2.03% (95% CI, 1.36–2.69%) quoted in an earlier study by Wang et al 9 which looked at VTE diagnosed on admission or at some point during admission. While the overall incidence of 6.1% perhaps represents the most appropriate risk for severe UC patients, the incidence of 4.5% (diagnosed during hospitalisation and within 1 month of discharge, but not on admission) better represents hospitalised UC patients’ risk for VTE.…”

“…On admission, the median C-reactive protein was 29 mg/L (IQR 7.7, 80.8) and haemoglobin was 12.1 g/dL (IQR 10.5, 13.4). The median length of stay was 6 days (IQR 3,9).…”

“…2 Furthermore, multiple studies have demonstrated that patients with inflammatory bowel disease (IBD) are at a 1.5-to 3.5-fold increased risk of developing symptomatic venous thromboembolism (VTE) when compared to non-IBD patients. [3][4][5][6][7][8][9][10] The increased risk of VTE is particularly elevated during periods of active disease and especially during hospitalisation. 4 Importantly, the mortality from symptomatic VTE in patients with IBD has been reported to be as high as 22% 11 and two-fold higher than non-IBD patients with VTE.…”

Meta‐analysis: the risk of venous thromboembolism in patients with inflammatory bowel disease

“…The possible association between IBD and VTE was first reported in 1936 by Bargen and Barker, who described 18 patients with thromboembolic disease (predominantly venous) from among more than 1000 patients treated for IBD at the Mayo Clinic . Since that time, several recent publications have suggested that patients with IBD have an increased risk of VTE, although some heterogeneity can be seen in the literature . For example, while Nguyen et al .…”

“…10 Since that time, several recent publications have suggested that patients with IBD have an increased risk of VTE 11 , although some heterogeneity can be seen in the literature. [12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28] For example, while Nguyen et al 17 reported that IBD patients may have a more than sevenfold increase in the risk of VTE, Saleh et al 21 identified a much lower risk.…”