Risk of Venous Thromboembolism With Inflammatory Bowel Disease

Saleh, Tarek; Matta, Fadi; Yaekoub, Abdo Y.; Danescu, Septimiu C.; Stein, Paul D.

doi:10.1177/1076029609360528

Cited by 46 publications

(28 citation statements)

References 16 publications

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“…reported that the incidence of venous thromboembolism among the CD patients discharged from hospitals throughout the United States was 1.22%. [40] Similarly, we found a significant association between the severity of the disease and the frequency of DVT in our patients, which is consistent with that reported in the literature. [41]…”

Section: Discussionsupporting

confidence: 92%

Clinical epidemiology and phenotypic characteristics of Crohn′s disease in the central region of Saudi Arabia

Aljebreen

Alharbi

Azzam

et al. 2014

Saudi J Gastroenterol

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Background/Aims:Despite the remarkable increase in the incidence of Crohn's disease among Saudis in recent years, data about Crohn's disease in Saudi Arabia are scarce. The aim of this study was to determine the clinical epidemiology and phenotypic characteristics of Crohn's disease in the central region of Saudi Arabia.Patients and Methods:A data registry, Inflammatory Bowel Disease Information System (IBDIS), was used to register Crohn's disease patients who presented to the gastroenterology clinics in four tertiary care centers in Riyadh, Saudi Arabia between September 2009 and February 2013. Patients’ characteristics, disease location, behavior, age at diagnosis according to the Montreal classification, course of the disease, and extraintestinal manifestation were recorded.Results:Among 497 patients with Crohn's disease, 59% were males with a mean age at diagnosis of 25 years [95% Confidence Interval (CI): 24-26, range 5-75 years]. The mean duration from the time of complaint to the day of the diagnosis was 11 months, and the mean duration of the disease from diagnosis to the day of entry to the registry was 40 months. Seventy-seven percent of our patients were aged 17-40 years at diagnosis, 16.8% were ≤16 years of age, and 6.6% were >40 years of age. According to the Montreal classification of disease location, 48.8% of patients had ileocolonic involvement, 43.5% had limited disease to the terminal ileum or cecum, 7.7% had isolated colonic involvement, and 16% had an upper gastrointestinal involvement. Forty-two percent of our patients had a non-stricturing, non-penetrating behavior, while 32.8% had stricturing disease and 25.4% had penetrating disease.Conclusion:Crohn's disease is frequently encountered in Saudi Arabia. The majority of patients are young people with a predilection for males, while its behavior resembled that of western societies in terms of age of onset, location, and behavior.

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Section: Discussionsupporting

confidence: 92%

Clinical epidemiology and phenotypic characteristics of Crohn′s disease in the central region of Saudi Arabia

Aljebreen

Alharbi

Azzam

et al. 2014

Saudi J Gastroenterol

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“…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 .…”

Section: Introductionmentioning

confidence: 99%

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

Yuhara

Steinmaus

Corley

et al. 2013

Aliment Pharmacol Ther

180

117

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Summary Background Inflammatory bowel disease (IBD), which includes Crohn's disease (CD) and ulcerative colitis (UC), is a systemic disorder that predominantly affects the bowels but is also associated with venous thromboembolism (VTE). Aim To provide a quantitative assessment of the association of IBD with venous thromboembolism risk and to explore the possible sources of heterogeneity in the current literature, a meta‐analysis of case–control and cohort studies was conducted. Methods Studies were identified by a literature search of the PubMed and Scopus databases (from inception inclusive 31 December 2012) for English language studies. Summary relative risks (RRs) with 95% confidence intervals (CIs) were calculated with fixed‐ and random‐effects models. Several subgroup analyses were performed to explore potential study heterogeneity and bias. Results Eleven studies met our inclusion criteria. The summary RR for deep venous thromboembolism (DVT) and pulmonary embolism (PE) comparing subjects both with and without IBD was 2.20 (95% CI 1.83–2.65). After adjusting for obesity and smoking, summary relative risks near 2.0 were seen for venous thromboembolism in both UC and CD patients. Conclusion This meta‐analysis showed that inflammatory bowel disease is associated with an approximately two‐fold increase in the risk of venous thromboembolism.

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“…In population based cohort studies, patients with IBD have a 1.5–3 fold increase in risk of venous thromboembolism 1, 2, 8, 9 . Furthermore, VTE in such patients is associated with considerable morbidity and mortality with higher rates of death from pulmonary embolism in IBD patients than the general population 5, 10 .…”

Section: Introductionmentioning

confidence: 99%

Venous Thromboembolism in Patients with Inflammatory Bowel Diseases

Scoville¹,

Konijeti²,

Nguyen³

et al. 2014

Inflammatory Bowel Diseases

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Introduction Inflammatory bowel disease is a well known risk factor for venous thromboembolism (VTE). Existing guidelines for thromboprophylaxis in hospitalized patients do not extend to other clinical scenarios that may also be associated with VTE risk. Our aim was to estimate the fraction of VTE events in IBD patients that could be prevented. Methods A retrospective analysis assessed all IBD patients diagnosed with VTE at a single academic medical center from 2002–2012. Confirmed cases were analyzed for VTE risk factors, inpatient status, the use of DVT prophylaxis, and when applicable the reason for omission of prophylaxis. IBD VTE cases were compared with age- and sex-matched non-IBD VTE controls with regards to risk factors and potential opportunities for VTE prevention. Results There were 204 IBD patients (108 UC, 96 CD) diagnosed with VTE (110 DVT, 66 PE, 27 intra-abdominal thromboses, 1 other). One third of the VTE events occurred in hospitalized patients. Two-third of the medical inpatients and 44% of surgical in-patients who developed VTE did not receive prophylaxis. Importantly, 129 VTE events occurred in outpatients. The proportion of outpatients hospitalized within 4 weeks of developing venous thrombosis was higher in IBD patients than non-IBD controls (33 vs. 15%, p=0.0003). One-third of patients (36%) were experiencing ambulatory disease flares at the time of VTE diagnosis. Conclusions A substantial portion of VTE events in IBD patients occurred in clinical scenarios not routinely recommended for thromboprophylaxis. Further investigation of primary prophylaxis for IBD patients in high risk outpatients may be warranted.

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Risk of Venous Thromboembolism With Inflammatory Bowel Disease

Cited by 46 publications

References 16 publications

Clinical epidemiology and phenotypic characteristics of Crohn′s disease in the central region of Saudi Arabia

Clinical epidemiology and phenotypic characteristics of Crohn′s disease in the central region of Saudi Arabia

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

Venous Thromboembolism in Patients with Inflammatory Bowel Diseases

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