Терапевтический архив (Jan 2025)
Prevention of venous thromboembolic complications in patients with ulcerative colitis
Abstract
Background. The incidence of venous thromboembolic complications (VTEC) in patients with inflammatory bowel diseases is approximately 3 times higher than in the general population and leads to a 2-fold increase in the risk of mortality. The risk of VTEC is the highest during the patient's hospital stay. Aim. To compare the overall VTEC risk in inpatients with ulcerative colitis (UC) with and without VTEC primary prevention. Materials and methods. In 2020, anticoagulant therapy was used for patients with UC in the case of acute venous thrombosis, and in 2022, primary thromboprophylaxis in patients with UC with moderate and high VTEC risk was based on the data obtained from the previous analysis of VTEC risk factors in inpatients with inflammatory bowel diseases. VTEC prophylaxis in UC patients was performed with a low molecular weight heparin (LMWH) – calcium nadroparin – at a dose of 0.3 mL (2850 IU anti-Xa) per day subcutaneously throughout the stay in the round-the-clock hospital. Results. In 2020, venous thrombosis was diagnosed in 16 (1.8%) patients with UC, including venous thrombosis of the lower extremities in 3 (0.3%) patients, venous thrombosis of the upper extremities in 7 (0.8%), pulmonary embolism in 2 (0.2%), and combined thrombosis in 4 (0.5%). In 2022, venous thrombosis was diagnosed in 5 (0.5%) patients with UC, including venous thrombosis of the lower extremities in 1 (0.1%) patient, venous thrombosis of the upper extremities in 3 (0.3%), and pulmonary embolism in 1 (0.1%). Thus, primary prevention with an LMWH significantly reduces the risk of VTEC in hospitalized patients with UC (relative risk 0.285, 95% confidence interval 0.103–0.774; χ2=6.917; p=0.009). Conclusion. Our results demonstrate that primary prevention with an LMWH significantly reduces the risk of VTEC in patients with UC hospitalized in a round-the-clock hospital.
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