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

Abstract

Background/AimsVenous 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.MethodsThe 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.ResultsVTE 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%.ConclusionsThe 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.

<p>Prevalence of Asymptomatic Venous Thromboembolism in Depressive Inpatients</p>

“…Abbreviation: VTE, venous thromboembolism. about the same as that in inpatients with inflammatory bowel disease, which has been reported at 5.3%, 22 and low compared to that in in-patients with advanced cancer or acute ischemic stroke, reported at 33.7% and 40.2%, respectively. 13,16 Inpatients with depression may thus have a lower prevalence of asymptomatic VTE than patients hospitalized for physical illness.…”

“…3,4 Studies that examined VTE in patients hospitalized at other departments reported 71.4-100% of cases to be asymptomatic. 14,15,17,[19][20][21][22]24,25 Asymptomatic VTE thus seems to be common in psychiatric as well as nonpsychiatric inpatients.…”

“…A VTE prevalence of 2.3-25.3% in hospitalized patients with psychiatric disorders does not seem high compared to the VTE prevalence in hospitalized patients with nonpsychiatric disorders. [2][3][4] The prevalence of VTE has been reported at 0.5-58% in hospitalized non postsurgical patients with nonpsychiatric disorders, [11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26] and at 4.8-24.4% in those without VTE symptoms. 14,17,19,24 Given the recent increase in the number of people requiring hospitalization for VTE, clarifying the prevalence of VTE in hospitalized patients with psychiatric disorders such as depression is of academic as well as of clinical value.…”

Incidence and risk factors for venous thrombosis among patients with inflammatory bowel disease in China: a multicenter retrospective study

“…Surprisingly, more than 50% of the reported thrombotic events were asymptomatic. 21,22 Therefore, proactive screening could be useful for early identification of thrombosis; this is especially important for thrombosis with atypical presentation such as intra-abdominal thrombosis. In our study, more patients developed intra-abdominal venous thrombosis than PE, and the reported symptoms were mostly nonspecific such as abdominal pain.…”

Clinical Case of Complicated Thrombophilia in a Patient with Ulcerative Colitis

“…Известно, что воспаление при ЯК приводит к изменениям в системе гемостаза: увеличению прокоагулянтных факторов и снижению фибринолитической активности, что при наличии генетической предрасположенности способствует манифестации тромбофилии [3,6,7]. Частота встречаемости тромбоза периферических вен и тром-Thrombophilia in a Patient with Ulcerative Colitis Тромбофилия у пациента с язвенным колитом боэмболии легочной артерии у больных ЯК больше в три раза по сравнению со здоровым населением, а при наличии у этих пациентов наследственных факторов риска, например, мутации фактора V Лейдена, риск тромботических событий возрастает в пять раз [3,8,9]. Описаний случаев тромбообразования в полости ПЖ при ЯК в имеющейся литературе нам найти не удалось.…”