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* = Presenting author

P206 Prevalence and risk factors for thromboembolic complications in IBD patients

A. Schoepfer*1, A. Alatri2, N. Fournier3, 4, E. Safroneeva5, L. Calanca2, L. Mazzolai2

1Centre Hospitalier Universitaire Vaudois, Gastroenterology and Hepatology, Lausanne, Switzerland, 2Centre Hospitalier Universitaire Vaudois, Angiology, Lausanne, Switzerland, 3Institute of Social and Preventive Medicine, Healthcare Evaluation Unit, Lausanne, Switzerland, 4University of Lausanne, IUMSP, Lausanne, Switzerland, 5University of Bern, Institute of Social and Preventive Medicine, Bern, Switzerland

Background

Inflammatory bowel disease (IBD) patients have an increased risk of venous thromboembolic complications (VTEC) such as deep vein thrombosis (DVT) and pulmonary embolism when compared to the non-IBD population. However, studies assessing VTEC prevalence in IBD as well as analyses of VTEC associated risk factors are scarce. We aimed to assess VTEC prevalence in IBD patients and to identify associated risk factors.

Methods

Data from patients enrolled in the Swiss IBD Cohort Study (SIBDCS) were analyzed. Since 2006 the SIBDCS collects data on a large sample of IBD patients from hospitals and private practices across Switzerland.

Results

A total of 90/2284 (3.94%) IBD patients suffered from VTEC. Of these, 45/1324 (3.4% overall; 2.42% with DVT, 1.51% with PE) had CD, and 45/960 (4.7% overall; 3.23% with DVT, 2.40% with PE) presented with UC.

In CD patients, median disease duration was 12 years in the VTEC group compared to 8 years in the CD group without VTEC (p=0.001). IBD-related intestinal surgery was more often performed in CD patients with VTEC compared to patients without VTEC (53.3% vs. 35.8%, p=0.016). No differences among the two groups were observed for perianal surgery (26.7% vs. 19.2%, p=0.216) or for disease location (p=0.596). UC-related intestinal surgery was more frequently encountered in the VTEC group compared to the one without VTEC (22.2% vs. 5.0%, p<0.001). Perianal surgery was not identified as risk factor for VTEC in CD patients (VTEC prevalence 4.4% in CD patients having undergone perianal surgery vs. 2.0% VTEC prevalence in CD patients not having undergone perianal surgery, p=0.240). UC patients with VTEC were found to suffer more frequently from pancolitis when compared to UC patients without VTEC (53.3% vs 40.3%, p=0.003). IBD treatment, including immunomodulators and anti-TNF agents, was used in similar frequencies in CD and UC patients with and without VTEC. Ciclosporin use was more prevalent in UC patients group with VTEC (15.6% vs. 6.0%, p=0.021). Logistic regression modeling found no significant association of VTEC with the following factors: age, gender, use of oral contraception, body mass index, smoking status, age at time of IBD diagnosis, and IBD family history.

Conclusion

IBD is associated with an important number of VTEC. VTEC were more prevalent in UC patients compared to CD patients. Intestinal surgery is a risk factor for VTEC in both UC and CD patients. Disease duration was identified as risk factor for VTEC in CD patients whereas pancolitis was significantly associated with VTEC in UC patients.