Intestinal Research (Jul 2018)

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

  • Katsuyoshi Ando,
  • Mikihiro Fujiya,
  • Yoshiki Nomura,
  • Yuhei Inaba,
  • Yuuya Sugiyama,
  • Takuya Iwama,
  • Masami Ijiri,
  • Keitaro Takahashi,
  • Kazuyuki Tanaka,
  • Aki Sakatani,
  • Nobuhiro Ueno,
  • Shin Kashima,
  • Kentaro Moriichi,
  • Yusuke Mizukami,
  • Toshikatsu Okumura

DOI
https://doi.org/10.5217/ir.2018.16.3.416
Journal volume & issue
Vol. 16, no. 3
pp. 416 – 425

Abstract

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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.

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