Unawareness of thromboprophylaxis is associated with low venous thromboembolism occurrence in hospitalized patients with acute inflammatory bowel disease flare.


Journal

Minerva medica
ISSN: 1827-1669
Titre abrégé: Minerva Med
Pays: Italy
ID NLM: 0400732

Informations de publication

Date de publication:
Dec 2020
Historique:
pubmed: 31 7 2020
medline: 1 1 2021
entrez: 31 7 2020
Statut: ppublish

Résumé

Inflammatory bowel disease (IBD) is a set of chronic inflammatory diseases associated with significant morbidity. Generally, IBD patients have twice the risk of venous thromboembolism (VTE) compared to healthy controls. VTE can occur both, during hospital stay or after discharge. We aimed to assess the incidence among IBD patients who were hospitalized for disease exacerbation. In a retrospective cross-sectional analysis all IBD patients who were admitted with disease exacerbation at Galilee Medical Center and Hadassah Medical Organization were included in the study. Excluding criteria was IBD with already known hypercoagulable state. One-hundred and sixteen patients with 176 admissions due to IBD flare were included in the study. The average age was 38.3±16.3 years. Sixty-six admissions (37.5%) occurred in patients with ulcerative colitis exacerbation and 110 in patients with Crohn's disease exacerbation (62.5%). Thirty-nine patients (22.1%) were smokers. Fifty-four patients (30.7%) and 68 patients (38.6%) were on previous (within 3 months) biological and steroid treatment, respectively. Twelve patients (6.8%) were on prophylactic subcutaneous anticoagulation (enoxaparin) throughout their hospital stay and only 3 patient (1.7%) developed in-hospital clinical VTE episode. The mean hospitalization length was 6.8±7.9 days and among patients who developed VTE episode, the length of stay was significantly higher as compared to patients without VTE episodes (36.7 vs. 6.3 days, P<0.0001). Notably, in-hospital IBD related-surgical procedure was the only risk factor for the development of VTE (Odds Ratio: 36.2; P=0.01). In-hospital VTE is rare among IBD patients admitted with exacerbation. Further studies are warranted to assess risk factors for in-hospital VTE development and to assess further the role of prophylactic anticoagulation among IBD patients with bloody diarrhea.

Sections du résumé

BACKGROUND BACKGROUND
Inflammatory bowel disease (IBD) is a set of chronic inflammatory diseases associated with significant morbidity. Generally, IBD patients have twice the risk of venous thromboembolism (VTE) compared to healthy controls. VTE can occur both, during hospital stay or after discharge. We aimed to assess the incidence among IBD patients who were hospitalized for disease exacerbation.
METHODS METHODS
In a retrospective cross-sectional analysis all IBD patients who were admitted with disease exacerbation at Galilee Medical Center and Hadassah Medical Organization were included in the study. Excluding criteria was IBD with already known hypercoagulable state.
RESULTS RESULTS
One-hundred and sixteen patients with 176 admissions due to IBD flare were included in the study. The average age was 38.3±16.3 years. Sixty-six admissions (37.5%) occurred in patients with ulcerative colitis exacerbation and 110 in patients with Crohn's disease exacerbation (62.5%). Thirty-nine patients (22.1%) were smokers. Fifty-four patients (30.7%) and 68 patients (38.6%) were on previous (within 3 months) biological and steroid treatment, respectively. Twelve patients (6.8%) were on prophylactic subcutaneous anticoagulation (enoxaparin) throughout their hospital stay and only 3 patient (1.7%) developed in-hospital clinical VTE episode. The mean hospitalization length was 6.8±7.9 days and among patients who developed VTE episode, the length of stay was significantly higher as compared to patients without VTE episodes (36.7 vs. 6.3 days, P<0.0001). Notably, in-hospital IBD related-surgical procedure was the only risk factor for the development of VTE (Odds Ratio: 36.2; P=0.01).
CONCLUSIONS CONCLUSIONS
In-hospital VTE is rare among IBD patients admitted with exacerbation. Further studies are warranted to assess risk factors for in-hospital VTE development and to assess further the role of prophylactic anticoagulation among IBD patients with bloody diarrhea.

Identifiants

pubmed: 32729705
pii: S0026-4806.20.06885-8
doi: 10.23736/S0026-4806.20.06885-8
doi:

Substances chimiques

Anticoagulants 0
Enoxaparin 0

Types de publication

Journal Article Multicenter Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

560-565

Auteurs

Wisam Sbeit (W)

Department of Gastroenterology, Galilee Medical Center, Nahariya, Israel.
Faculty of Medicine in the Galilee, Bar-Ilan University, Safed, Israel.

Anas Kadah (A)

Department of Gastroenterology, Galilee Medical Center, Nahariya, Israel.
Faculty of Medicine in the Galilee, Bar-Ilan University, Safed, Israel.

Asher Shafrir (A)

Department of Gastroenterology, Hadassah Medical Organization, Hebrew University, Jerusalem, Israel.

Itai Kalisky (I)

Department of Gastroenterology, Hadassah Medical Organization, Hebrew University, Jerusalem, Israel.

Mahmud Mahamid (M)

Department of Gastroenterology, Sharee Zedek Medical Center, Jerusalem, Israel.

Wadi Hazou (W)

Department of Gastroenterology, Hadassah Medical Organization, Hebrew University, Jerusalem, Israel.

Lior Katz (L)

Department of Gastroenterology, Hadassah Medical Organization, Hebrew University, Jerusalem, Israel.

Amir Mari (A)

Faculty of Medicine in the Galilee, Bar-Ilan University, Safed, Israel - amir.mari@hotmail.com.
Unit of Gastroenterology, The Nazareth Hospital, EMMS, Nazareth, Israel.
Unit of Endoscopy, The Nazareth Hospital, EMMS, Nazareth, Israel.

Tawfik Khoury (T)

Department of Gastroenterology, Galilee Medical Center, Nahariya, Israel.
Faculty of Medicine in the Galilee, Bar-Ilan University, Safed, Israel.
Unit of Gastroenterology, The Nazareth Hospital, EMMS, Nazareth, Israel.
Unit of Endoscopy, The Nazareth Hospital, EMMS, Nazareth, Israel.

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