The increasing incidence of thromboembolic events among hospitalized patients with inflammatory bowel disease

Vascular ◽  
2014 ◽  
Vol 23 (3) ◽  
pp. 260-264 ◽  
Author(s):  
SreyRam Kuy ◽  
Anahita Dua ◽  
Rohit Chappidi ◽  
Gary Seabrook ◽  
Kellie R Brown ◽  
...  

Background We performed a national population-based study examining the incidence of both venous and arterial thromboembolic events in patients hospitalized with inflammatory bowel disease over the past decade. Methods A retrospective cross-sectional analysis using the Nationwide Inpatient Sample Database was performed. Patients hospitalized with Crohn’s disease and ulcerative colitis were identified using ICD-9 codes. The incidence of clinically relevant venous thromboembolic events and arterial thromboembolic events including myocardial infarction, visceral ischemia, cerebrovascular accidents, and peripheral arterial events was examined. Results During the study period, 461,415 hospitalized inflammatory bowel disease patients were identified. Among these patients, 28,820 had a diagnosis of a thromboembolic event (overall prevalence of 6%). The incidence of thromboembolic events in patients with inflammatory bowel disease rose from 5.65% in 2000 to 7.17% by 2009. There were 18,270 (3.96%) patients who had an arterial thrombotic event, the most common being myocardial infarction (50%), followed by visceral ischemia (25%), and cerebrovascular incidents (22%). There were 11,083 (2.4%) patients identified to have had a venous thrombotic event, with the most common manifestation being deep vein thrombosis (77%), pulmonary embolism (32%), and portal vein thrombosis (3.9%). Conclusion An increasing incidence of thromboembolic event in patients with inflammatory bowel disease was observed over the past decade. Interestingly, there were more arterial thrombotic events in comparison to venous thrombotic events.

2020 ◽  
Vol 158 (6) ◽  
pp. S-933-S-934
Author(s):  
Paul T. Kröner ◽  
Luisa Cruz ◽  
Alex M. Kesler ◽  
Monia E. Werlang ◽  
Freddy Caldera ◽  
...  

2021 ◽  
Vol 14 ◽  
pp. 175628482098819
Author(s):  
Klaudia Farkas ◽  
Daniella Pigniczki ◽  
Mariann Rutka ◽  
Kata Judit Szántó ◽  
Tamás Resál ◽  
...  

The coronavirus disease 2019 (COVID-19) outbreak emerged in December 2019 in China and rapidly spread worldwide. Inflammatory bowel disease (IBD) patients are likely to be more susceptible to viral infections, and this is significantly influenced by the type of therapy they receive. Thus, issues specifically concerning the medical treatment of IBD patients were shortly addressed at the beginning of the pandemic. However, recently available data on the occurrence and outcome of SARS-CoV-2 infection in IBD patients does not address the concerns raised at the beginning of the pandemic. Growing evidence and the rapid changes happening over the past few weeks have helped elucidate the current situation, contribute to our understanding of the disease, and many previously raised questions could now be answered. We hereby summarise available evidence regarding viral infections and IBD, focusing on SARS-CoV infections, and we provide practical recommendations related to patient management during the COVID-19 pandemic era.


2004 ◽  
Vol 18 (4) ◽  
pp. 255-257
Author(s):  
Robert Hilsden

Longobardi and colleagues examined the effect of inflammatory bowel disease (IBD) on employment, using data from 10,891 respondents aged 20 to 64 years from the 1998 cycle of the Canadian National Population Health Survey (NPHS) (1). This sample included 187 (1.7%) subjects who self-reported IBD or a similar bowel disorder. A significantly greater proportion of IBD than non-IBD respondents reported that they were not in the labour force (28.9% versus 18.5%). Even after adjusting for other factors (age group, level of pain, etc), subjects with IBD had a 2.9% higher nonparticipation rate (21.4%). For example, among people not hospitalized within the past year and with no limitation of activities due to pain, IBD subjects were 1.2 times more likely to be unemployed than those without IBD. Subjects who reported high levels of pain had a very high probability of being out of the labour force. Based on Canadian annual compensation data for all employed persons in Canada, and age- and sex-specific prevalence, and incidence rates for IBD, the authors estimated that there are 119,980 IBD patients between the ages of 20 and 64 years in Canada and that this group includes 3479 people who are not in the labour force. This translates into lost wages of $104.2 million, or $868 per IBD patient


2021 ◽  
Vol 24 (2) ◽  
pp. 39-41
Author(s):  
Fabiana Di Stasio ◽  
Angela Amoroso ◽  
Naire Sansotta ◽  
Valeria Casotti ◽  
Lorenzo D'Antiga

Venous thromboembolism (VTE) is a serious extraintestinal complication of inflammatory bowel disease (IBD). Patients with IBD have a VTE risk 3 times greater than those without IBD. IBD children are exposed to that risk as well but with lower incidence compared to adults, 9 events per 10,000 patients per years in children. The acute IBD flare is a predisposing factor to VTE. The management of thromboembolism in IBD patients includes treatment of a thromboembolic complication and secondary prophylaxis of the recurrence of a thromboembolic event. The paper reports a case of a boy with ulcerative colitis who developed cerebrovascular VTE during IBD flare.


Author(s):  
Leonard Naymagon ◽  
Douglas Tremblay ◽  
Nicole Zubizarreta ◽  
Erin Moshier ◽  
Steven Naymagon ◽  
...  

Abstract Background Portal vein thrombosis (PVT) is a poorly described complication of inflammatory bowel disease (IBD). We sought to better characterize presentations, compare treatments, and assess outcomes in IBD-related PVT. Methods We conducted a retrospective investigation of IBD-related PVT at our institution. Multivariable Cox proportional hazards modeling was used to estimate adjusted hazard ratios across treatments. Results Sixty-three patients with IBD-related PVT (26 with Crohn disease, 37 with ulcerative colitis) were followed for a median 21 months (interquartile ratio [IQR] = 9-52). Major risk factors included intra-abdominal surgery (60%), IBD flare (33%), and intra-abdominal infection (13%). Primary hematologic thrombophilias were rare and did not impact management. Presentations were generally nonspecific, and diagnosis was incidental. Ninety-two percent of patients (58/63) received anticoagulation (AC), including 23 who received direct oral anticoagulants (DOACs), 22 who received warfarin, and 13 who received enoxaparin. All anticoagulated patients started AC within 3 days of diagnosis. Complete radiographic resolution (CRR) of PVT occurred in 71% of patients. We found that DOACs were associated with higher CRR rates (22/23; 96%) relative to warfarin (12/22; 55%): the hazard ratio of DOACs to warfarin was 4.04 (1.83-8.93; P = 0.0006)). Patients receiving DOACs required shorter courses of AC (median 3.9 months; IQR = 2.7-6.1) than those receiving warfarin (median 8.5 months; IQR = 3.9-NA; P = 0.0190). Incidence of gut ischemia (n = 3), symptomatic portal hypertension (n = 3), major bleeding (n = 4), and death (n = 2) were rare, and no patients receiving DOACs experienced these adverse outcomes. Conclusions We show that early and aggressive use of AC can lead to excellent outcomes in IBD-associated PVT and that DOACs are associated with particularly favorable outcomes in this setting.


2021 ◽  
Vol 160 (6) ◽  
pp. S-358
Author(s):  
Andres Yarur ◽  
Fan Mu ◽  
Miriam L. Zichlin ◽  
Emma Billmyer ◽  
Nathaniel Downes ◽  
...  

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