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Minerva Medica 2020 December;111(6):560-5

DOI: 10.23736/S0026-4806.20.06885-8


language: English

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

Wisam SBEIT 1, 2, Anas KADAH 1, 2, Asher SHAFRIR 3, Itai KALISKY 3, Mahmud MAHAMID 4, Wadi HAZOU 3, Lior KATZ 3, Amir MARI 2, 5, 6 , Tawfik KHOURY 1, 2, 5, 6

1 Department of Gastroenterology, Galilee Medical Center, Nahariya, Israel; 2 Faculty of Medicine in the Galilee, Bar-Ilan University, Safed, Israel; 3 Department of Gastroenterology, Hadassah Medical Organization, Hebrew University, Jerusalem, Israel; 4 Department of Gastroenterology, Sharee Zedek Medical Center, Jerusalem, Israel; 5 Unit of Gastroenterology, The Nazareth Hospital, EMMS, Nazareth, Israel; 6 Unit of Endoscopy, The Nazareth Hospital, EMMS, Nazareth, Israel

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: 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: 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: 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.

KEY WORDS: Inflammatory bowel diseases; Venous thromboembolism; Anticoagulants

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