Thromboprophylaxis for Hospitalized Patients with Inflammatory Bowel Disease—Are We There Yet?
Abstract
:1. Introduction
2. Materials and Methods
2.1. Data Collection of Patients with IBD
2.2. Cohort IBD Analysis
2.3. VTE Diagnosis and Treatment
2.4. Statistical Analysis
3. Results
3.1. Emergency Department Visits of Patients with IBD
3.2. Prophylactic Anticoagulation during All Hospitalizations
3.3. Clinical Characteristics of All New VTE Patients
3.4. Newly Diagnosed VTE during Hospitalization
3.5. Prophylactic Anticoagulation during Hospitalizations of VTE Events
3.6. Newly Diagnosed VTE in the ED
3.7. Hospitalizations in the Previous 14 Days before VTE Diagnosis
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Conflicts of Interest
References
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ED Visits, n | 7009 |
Total patients, n | 2405 |
Visits per patient, average (SD) | 2.91 (± 5.3) |
Male, n (% of total patients) Female, n (% of total patients) | 1216 (50.5) 1189 (49.5) |
Crohn’s disease, n (% of total patients) | 1556 (64.7) |
Ulcerative colitis, n (% of total patients) | 849 (35.3) |
Age of admission, median years (IQR) | 42 (28–65) |
IBD-related complaints, n (% of ED visits) | 3305 (47.2) |
Total hospitalizations, n (% of ED visits) | 3967 (56.6) |
Hospitalization unit, n (% of total hospitalizations) | |
General surgery | 1510 (38.1) |
Internal medicine and geriatrics | 1505 (37.9) |
Short-term hospitalization unit | 297 (7.5) |
Pediatrics | 226 (5.7) |
Cardiology | 76 (1.9) |
Others (Orthopedics, Urology, Oncology, Gynecology) | 353 (8.9) |
Hospitalization length in days, median (IQR) | 4 (2–7) |
Return to ED in 30 days (% of ED visits) | 1303 (18.6) |
VTE prophylaxis, n (% of total hospitalizations) | 463 (11.7) |
Patients with Newly Diagnosed VTE | 36 |
ED diagnosis, n (% of VTE) | 19 (52.8) |
Hospitalization diagnosis, n (% of VTE) | 17 (47.2) |
Male, n (%) | 18 (50) |
Female, n (%) | 18 (50) |
Single VTE, n (% of patients) | 30 (83.3) |
Double VTE, n (% of patients) | 6 (16.6) |
DVT, n (%) | 34 (94.4) |
PE, n (%) | 8 (22.2) |
DVT location, n (% of DVTs) | |
Proximal | 28 (82.4) |
Distal | 9 (26.5) |
Age at onset of VTE, median (IQR) | 64.5 (48.25–79.25) |
Additional thrombosis-related risk factors, n (%) | |
Malignancy | 6 (16.7) |
Post-operative period | 6 (16.7) |
Bedridden | 4 (12.5) |
Central venous access | 2 (5.5) |
No risk factors | 21 (58.3) |
CD, n (%) | 18 (50) |
UC, n (%) | 18 (50) |
CD extent, n (% of CD patients) | |
L1 (ileal) | 3 (16.6) |
L2 (colonic) | 2 (11.1) |
L3 (ileo-colonic) | 10 (55.6) |
CD behavior, n (% of patients with CD) | |
B1 (non-stricturing and non-penetrating) | 7 (38.9) |
B2 (stricturing) | 5 (27.8) |
B3 (penetrating) | 4 (22.2) |
UC extent, n (% of patients with UC) | |
E1 (proctitis) | 1 (33.3) |
E2 (left sided colitis) | 2 (66.7) |
E3 (right sided colitis) | 0 (0) |
Additional extra-intestinal manifestations | 8 (22.2) |
Current IBD therapy, n (%) | |
5-ASA derivatives | 18 (50) |
Steroids | 8 (22.2) |
Biologics | 7 (19.4) |
Immunomodulators | 11 (30.6) |
IBD-Related Diagnosis, n (% of hospitalization VTE) | 6 (35.3) |
Hospitalization length, median (IQR) | 21 (7–42.5) |
Hospitalization unit, n (%) | |
Internal medicine and geriatrics | 11 (64.7) |
General surgery | 5 (29.4) |
Orthopedics | 1 (5.9) |
Mortality, n (% of hospitalization VTE) | |
In-hospitalization | 1 (5.9) |
30 days post-discharge | 1 (5.9) |
90 days post-discharge | 1 (5.9) |
Anticoagulation, n (% of hospitalization VTE) | |
Prophylaxis | 5 (29.4) |
Therapeutic | 4 (23.5) |
None | 8 (47.1) |
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Levartovsky, A.; Barash, Y.; Ben-Horin, S.; Ungar, B.; Klang, E.; Soffer, S.; Kopylov, U. Thromboprophylaxis for Hospitalized Patients with Inflammatory Bowel Disease—Are We There Yet? J. Clin. Med. 2020, 9, 2753. https://doi.org/10.3390/jcm9092753
Levartovsky A, Barash Y, Ben-Horin S, Ungar B, Klang E, Soffer S, Kopylov U. Thromboprophylaxis for Hospitalized Patients with Inflammatory Bowel Disease—Are We There Yet? Journal of Clinical Medicine. 2020; 9(9):2753. https://doi.org/10.3390/jcm9092753
Chicago/Turabian StyleLevartovsky, Asaf, Yiftach Barash, Shomron Ben-Horin, Bella Ungar, Eyal Klang, Shelly Soffer, and Uri Kopylov. 2020. "Thromboprophylaxis for Hospitalized Patients with Inflammatory Bowel Disease—Are We There Yet?" Journal of Clinical Medicine 9, no. 9: 2753. https://doi.org/10.3390/jcm9092753