The Incidence and Risk Factors of Venous Thromboembolism in Patients with Inflammatory Bowel Disease: A Prospective Multicenter Cohort Study

Abstract

<b><i>Background:</i></b> Venous thromboembolism (VTE) has been shown to be more frequent in inflammatory bowel disease (IBD) than in the general population in Western studies. However, the actual state of VTE in Asian IBD remains poorly understood. <b><i>Aims:</i></b> To reveal the incidence of VTE in IBD patients in Japan. <b><i>Methods:</i></b> Eighty-five patients admitted to 3 gastroenterology centers were registered from 2013 to 2018. The incidence of VTE in patients with IBD (<i>n</i> = 42) was prospectively compared to that among patients with other digestive diseases (<i>n</i> = 43). The presence of VTE was surveyed using contrast-enhanced computed tomography and/or ultrasonography at admission and at 1–2 weeks after admission. The patient characteristics and laboratory data of IBD patients with or without VTE were compared to determine the risk factors for VTE. <b><i>Results:</i></b> The incidence of VTE with IBD was 16.7%, which was significantly more frequent than with other digestive diseases (2.3%; <i>p</i> = 0.0296). In IBD patients, VTE was detected in 6 of 22 patients with ulcerative colitis (27.2%) but in only 1 of 20 patients with Crohn’s disease (5.0%). VTE was diagnosed at admission in 4 IBD patients and 2 weeks after admission in 3 IBD patients. The risk factors of VTE in IBD were the presence of an indwelling central venous catheter, a low level of total protein, a low activated partial thromboplastin time, and a high level of fibrinogen degradation products. <b><i>Conclusion:</i></b> VTE was frequently detected in Japanese IBD patients both at and after admission. Adequate screening and prophylaxis for VTE is deemed necessary in IBD.

Serine proteases at the cutting edge of IBD: Focus on gastrointestinal inflammation

“…In agreement with these findings, functional proteomic profiling has recently identified cathepsin G in UC mucosa but not in CD biopsies, highlighting thus significant differences in terms of proteolytic activities and protein profiles between the most common subtypes of IBD 91 . Seeing that gut inflammation and coagulation are two inter‐dependent processes, targeting such interface has been also a major focus of research related to IBD 92‐95 . In that setting, thrombin, a serine protease released upon tissue damage, seems as a potential candidate 96 .…”

Risk of venous thromboembolism in Asian patients with inflammatory bowel disease: a nationwide cohort study

“…Few studies have previously examined the risk of VTE in Asian patients with IBD [16][17][18][19] . Most of the studies have focused on the overall risk of VTE in IBD patients compared with the general population.…”

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.…”