Should Surgical Inflammatory Bowel Disease Patients Be Given Extended Venous Thromboembolic Prophylaxis Postoperatively?

2019 ◽  
Vol 26 (2) ◽  
pp. 289-290
Author(s):  
Amy L Lightner
Keyword(s):  
Risk Factors ◽  
Inflammatory Bowel Disease ◽  
Venous Thromboembolism ◽  
Postoperative Period ◽  
Bowel Disease ◽  
Surgical Patients ◽  
Optimal Management ◽  
Thromboembolic Prophylaxis ◽  
Venous Thromboembolic ◽  
Inflammatory Bowel

Venous thromboembolism is increased in inflammatory bowel disease surgical patients. Optimal management and prevention of portomeseteric venous thromboembolism is largely unknown, as are risk factors for development in the postoperative period.

Risk Factors for Venous Thromboembolism in Children and Young Adults With Inflammatory Bowel Disease

2019 ◽  
Vol 243 ◽  
pp. 173-179 ◽  
Author(s):  
Kerri McKie ◽  
Robert J. McLoughlin ◽  
Michael P. Hirsh ◽  
Muriel A. Cleary ◽  
Jeremy T. Aidlen
Keyword(s):  
Risk Factors ◽  
Inflammatory Bowel Disease ◽  
Young Adults ◽  
Venous Thromboembolism ◽  
Bowel Disease ◽  
Inflammatory Bowel ◽  
Children And Young Adults

Prevalence and risk factors for venous thromboembolic complications in the Swiss Inflammatory Bowel Disease Cohort

2016 ◽  
Vol 51 (10) ◽  
pp. 1200-1205 ◽  
Author(s):  
Adriano Alatri ◽  
Alain Schoepfer ◽  
Nicolas Fournier ◽  
Rolf Peter Engelberger ◽  
Ekaterina Safroneeva ◽  
...  
Keyword(s):  
Risk Factors ◽  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Thromboembolic Complications ◽  
Venous Thromboembolic ◽  
Inflammatory Bowel

scholarly journals Risk Factors of Venous Thromboembolism in Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 8 ◽  
Author(s):  
Hua Zhang ◽  
Xuehong Wang
Keyword(s):  
Risk Factors ◽  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Venous Thromboembolism ◽  
Bowel Disease ◽  
Meta Analysis ◽  
Random Effect ◽  
Female Gender ◽  
Medication History ◽  
Inflammatory Bowel

Background: Patients suffering from chronic inflammatory disorders, such as inflammatory bowel disorder, are at higher risk of developing thromboembolism. The chronic inflammatory nature of inflammatory bowel disease has been identified as a predominant reason for a state of Virchow's triad (i.e., endothelial dysfunction, stasis, and general hypercoagulability), eventually leading to the onset of venous thromboembolism. Recent studies show that certain factors, such as demographics, medication history, and history of surgical intervention may increase thromboembolism risk in patients with inflammatory bowel disease. However, to date, no study has attempted to evaluate the effect of different risk factors associated with the development of venous thromboembolism in inflammatory bowel disease patients.Objective: To evaluate the risk factors that can influence the incidence of venous thromboembolism in patients with inflammatory bowel disease.Methods: Academic literature was systematically searched based on the PRISMA guidelines across five databases: Web of Science, EMBASE, CENTRAL, Scopus, and MEDLINE. A random-effect meta-analysis was conducted to evaluate the hazard ratio for the risk factors (i.e., aging, gender, steroid therapy, surgery, and ulcerative colitis) that can influence the incidence of venous thromboembolism in patients with inflammatory bowel disease.Results: From a total of 963 studies, 18 eligible studies with 1,062,985 (44.59 ± 10.18 years) patients suffering from inflammatory bowel disease were included in the review. A meta-analysis revealed a higher risk of aging (Hazard's ratio: 2.19), steroids (1.87), surgery (1.48), and ulcerative colitis (2.06) on venous thromboembolism in patients with inflammatory bowel disease. We also found that the female gender (0.92) did not increase the incidence of venous thromboembolism in inflammatory bowel disease patients.Conclusion: The study provides preliminary evidence regarding high risks associated with ulcerative colitis, steroid consumption, and aging for the development of venous thromboembolism in patients with inflammatory bowel disease. The findings from this study may contribute to developing awareness among clinicians, better risk stratification and prevention of venous thromboembolic complications in patients with inflammatory bowel disease.

scholarly journals Venous Thromboembolism in Patients with Inflammatory Bowel Disease: The Role of Pharmacological Therapy and Surgery

2020 ◽  
Vol 9 (7) ◽  
pp. 2115
Author(s):  
Alfredo Papa ◽  
Antonio Tursi ◽  
Silvio Danese ◽  
Gianludovico Rapaccini ◽  
Antonio Gasbarrini ◽  
...  
Keyword(s):  
Risk Factors ◽  
Inflammatory Bowel Disease ◽  
Venous Thromboembolism ◽  
Bowel Disease ◽  
Pharmacological Therapy ◽  
Increased Risk ◽  
Relevant Role ◽  
Inflammatory Bowel ◽  
The Individual

Patients with inflammatory bowel disease (IBD) have an increased risk of venous thromboembolism (VTE). Alongside the traditional acquired and genetic risk factors for VTE, patients with IBD have pathogenic and clinical peculiarities that are responsible for the increased number of thromboembolic events occurring during their life. A relevant role in modifying this risk in a pro or antithrombotic manner is played by pharmacological therapies and surgery. The availability of several biological agents and small-molecule drugs with different mechanisms of action allows us to also tailor the treatment based on the individual prothrombotic risk to reduce the occurrence of VTE. Available review articles did not provide sufficient and updated knowledge on this topic. Therefore, we assessed the role of each single treatment, including surgery, in modifying the risk of VTE in patients with IBD to provide physicians with recommendations to minimize VTE occurrence. We found that the use of steroids, particularly if prolonged, increased VTE risk, whereas the use of infliximab seemed to reduce such risk. The data relating to the hypothesized prothrombotic risk of tofacitinib were insufficient to draw definitive conclusions. Moreover, surgery has an increased prothrombotic risk. Therefore, implementing measures to prevent VTE, not only with pharmacological prophylaxis but also by reducing patient- and surgery-specific risk factors, is necessary. Our findings confirm the importance of the knowledge of the effect of each single drug or surgery on the overall VTE risk in patients with IBD, even if further data, particularly regarding newer drugs, are needed.

Risk of Venous Thromboembolism After Hospital Discharge in Patients With Inflammatory Bowel Disease: A Population-based Study

2020 ◽  
Vol 26 (11) ◽  
pp. 1761-1768 ◽  
Author(s):  
Jeffrey D McCurdy ◽  
M Ellen Kuenzig ◽  
Glenys Smith ◽  
Sarah Spruin ◽  
Sanjay K Murthy ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Venous Thromboembolism ◽  
Propensity Score ◽  
Bowel Disease ◽  
Population Based ◽  
Surgical Patients ◽  
Data Sets ◽  
Kaplan Meier ◽  
Inflammatory Bowel

Abstract Background Inflammatory bowel disease (IBD) is associated with a high risk of venous thromboembolism (VTE) during hospitalization. It is unclear if this association persists after discharge. We aimed to assess the incidence of postdischarge VTE in IBD patients and to determine if IBD is associated with increased VTE risk. Methods We performed a population-based cohort study between 2002 and 2016 using Ontario health administrative data sets. Hospitalized (≥72 hours) adults with IBD were stratified into nonsurgical and surgical cohorts and matched on propensity score to non-IBD controls. Time to postdischarge VTE was assessed by Kaplan-Meier methods, and VTE risk was assessed by Cox proportional hazard models. Results A total of 81,900 IBD discharges (62,848 nonsurgical and 19,052 surgical) were matched to non-IBD controls. The cumulative incidence of VTE at 12 months after discharge was 2.3% for nonsurgical IBD patients and 1.6% for surgical IBD patients. The incidence increased in the nonsurgical IBD cohort by 4% per year (incidence rate ratio, 1.04; 95% CI, 1.02–1.05). In our propensity score-matched analysis, the risk of VTE at 1-month postdischarge was greater in nonsurgical IBD patients (hazard ratio [HR], 1.72; 95% CI, 1.51–1.96) and surgical patients with ulcerative colitis (HR, 1.68; 95% CI, 1.16–2.45) but not surgical patients with Crohn’s disease. These trends persisted through 12 months. Conclusions Nonsurgical IBD patients and surgical patients with ulcerative colitis are 1.7-fold more likely to develop postdischarge VTE than non-IBD patients. These findings support the need for increased vigilance and consideration of thromboprophylaxis in this population.

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