Thromboprophylaxis Is Associated With Reduced Post-hospitalization Venous Thromboembolic Events in Patients With Inflammatory Bowel Diseases
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Szolovits_Thromboprophylaxis.pdf
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Author(s)
Ananthakrishnan, Ashwin N.
Cagan, Andrew
Gainer, Vivian S.
Cheng, Su-Chun
Cai, Tianxi
Scoville, Elizabeth
Konijeti, Gauree G.
Szolovits, Peter
Shaw, Stanley Y.
Churchill, Susanne
Date Issued
March 2014
Journal
Clinical Gastroenterology and Hepatology
Publisher
Elsevier
Citation
Ananthakrishnan, Ashwin N., Andrew Cagan, Vivian S. Gainer, Su-Chun Cheng, Tianxi Cai, Elizabeth Scoville, Gauree G. Konijeti, et al. “Thromboprophylaxis Is Associated With Reduced Post-Hospitalization Venous Thromboembolic Events in Patients With Inflammatory Bowel Diseases.” Clinical Gastroenterology and Hepatology 12, no. 11 (November 2014): 1905–1910.
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Author's final manuscript
Abstract
Background & Aims
Patients with inflammatory bowel diseases (IBDs) have increased risk for venous thromboembolism (VTE); those who require hospitalization have particularly high risk. Few hospitalized patients with IBD receive thromboprophylaxis. We analyzed the frequency of VTE after IBD-related hospitalization, risk factors for post-hospitalization VTE, and the efficacy of prophylaxis in preventing post-hospitalization VTE.
Methods
In a retrospective study, we analyzed data from a multi-institutional cohort of patients with Crohn's disease or ulcerative colitis and at least 1 IBD-related hospitalization. Our primary outcome was a VTE event. All patients contributed person-time from the date of the index hospitalization to development of VTE, subsequent hospitalization, or end of follow-up. Our main predictor variable was pharmacologic thromboprophylaxis. Cox proportional hazard models adjusting for potential confounders were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs).
Results
From a cohort of 2788 patients with at least 1 IBD-related hospitalization, 62 patients developed VTE after discharge (2%). Incidences of VTE at 30, 60, 90, and 180 days after the index hospitalization were 3.7/1000, 4.1/1000, 5.4/1000, and 9.4/1000 person-days, respectively. Pharmacologic thromboprophylaxis during the index hospital stay was associated with a significantly lower risk of post-hospitalization VTE (HR, 0.46; 95% CI, 0.22–0.97). Increased numbers of comorbidities (HR, 1.30; 95% CI, 1.16–1.47) and need for corticosteroids before hospitalization (HR, 1.71; 95% CI, 1.02–2.87) were also independently associated with risk of VTE. Length of hospitalization or surgery during index hospitalization was not associated with post-hospitalization VTE.
Conclusions
Pharmacologic thromboprophylaxis during IBD-related hospitalization is associated with reduced risk of post-hospitalization VTE.
MIT Department
Massachusetts Institute of Technology. Department of Electrical Engineering and Computer Science
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Creative Commons Attribution-NonCommercial-NoDerivs License
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DOI of Published Version
https://doi.org/10.1016/j.cgh.2014.02.034
