Search in the Abstract Database

Abstracts Search 2017

* = Presenting author

P231 Backgrounds and D-dimer on admission are useful factors for predicting venous thromboembolic complications in hospitalized patients with inflammatory bowel disease

Ohta Y., Taida T., Nakagawa T., Hamanaka S., Koseki H., Okimoto K., Maruoka D., Matsumura T., Arai M., Katsuno T.

Chiba University, Department of Gastroenterology and Nephrology, Chiba City, Japan

Background

Venous thromboembolism (VTE) is known as one of the complications of inflammatory bowel disease (IBD). VTE demonstrates serious extraintestinal manifestations complicating the clinical course of IBD and can lead to significant morbidity and mortality. Therefore, clinician's awareness of the risks of VTE in hospitalization will help the management of thromboembolic complications in IBD. The aim of the present study was to identify the predictive factors of VTE in hospitalized patients with IBD.

Methods

We evaluated patients with IBD who were hospitalized from February 2015 to March 2016. We defined the VTE onset within two months after the admission as the primary endpoint. VTE was diagnosed by enhanced computed tomography. We analyzed the relations between VTE onset and the patient factors including their clinical backgrounds, laboratory test data in hospitalization, and inserting the central venous catheter. Also we evaluated the utility of Caprini score and Padua score at the time of admission.

Results

Eighty-nine IBD cases (31 patients with ulcerative colitis and 58 patients with Crohn's disease; 60 men and 29 women) had been hospitalized and treated. Central venous catheter was placed in 43 patients. During the observation period, VTE had been occurred in seven cases (7.9%). Average age in IBD patients with VTE was 46.6±9.4 years old compared to 36.6±14.7 years old in patients without VTE. Median disease duration in IBD patients with VTE was 5.8±5.1 years compared to 7.4±9.0 years in patients without VTE. Univariate and stepwise multiple logistic regression analysis identified age at hospitalization (AGE; odds ratio (OR) 1.07, 95% confidence interval (CI) 0.99–1.17, p<0.08), gender (GEN; OR 8.89, 95% CI 0.93–183.3, p<0.06) and D-dimer value on admission (DD; OR 1.86, 95% CI 1.27–3.22, p<0.0009) as the risk factors highly associated with VTE onset. The calculation formula {−6.411 + 0.619DD + 0.065AGE − 1.092GEN (man: 0, woman: 1)} >0 significantly predicted the occurrence of VTE during hospitalization (p<0.0007, AUC=0.96). Meanwhile, the association between VTE onset and thrombosis risk score such as Caprini score and Padua score was not provided.

Conclusion

In hospitalized patients with IBD, gender, age, and D-dimer value on admission were highly related with VTE onset. The calculation formula using these factors significantly predicted the occurrence of VTE. The patient information and laboratory data on admission are critical for the management of thromboembolic complications in patients with IBD.