Inflammatory bowel disease patients have higher risk of venous thromboembolism

January 01, 0001

Inflammatory bowel disease patients have higher risk of venous thromboembolism

Patients with inflammatory bowel disease who develop deep vein thrombosis or pulmonary embolism often have active disease at the time of thromboembolism. The researchers fom the UK therefore aimed to quantify the risk of venous thromboembolism prospectively during different activity phases of inflammatory bowel disease. From the General Practice Research Database, they matched patients with prospectively recorded inflammatory bowel disease from November, 1987, until July, 2001 with up to five controls by age, sex, and general practice. A flare was defined as the period 120 days after a new corticosteroid prescription. 13,756 patients with inflammatory bowel disease and 71,672 matched controls were included in the analysis, and of these 139 patients and 165 controls developed venous thromboembolism.

Overall, patients with inflammatory bowel disease had a significant higher risk of venous thromboembolism than did controls (hazard ratio 3.4, absolute risk 2.6 per 1000 per person-years). At the time of a flare, however, this increase in risk was significantly much more prominent (8.4, 9.0 per 1000 person- years). This relative risk at the time of a flare was significantly higher during non- hospitalised periods (15.8, 6.4 per 1000 person-years) than during hospitalised periods (3.2, 37.5 per 1000 person-years).

The researchers concluded: "Trials of primary prophylaxis of venous thromboembolism are warranted to find out whether this important complication can be prevented."

This is an important association and may be preventable.

For the full abstract, click here.

The Lancet 375:657 - 663, 20 February 2010 © 2010 Elsevier Ltd
Venous thromboembolism during active disease and remission in inflammatory bowel disease: a cohort study. Matthew J Grainge, Joe West, Timothy R Card.

Category: D. Digestive, K. Circulatory. Keywords: venous thromboembolism, inflammatory bowel disease, active, remission, cohort study, journal watch.
Synopsis edited by Dr Stephen Wilkinson, Melbourne, Australia. Posted on Global Family Doctor 12 March 2010

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.