Risk for VTE Remains in Patients With IBD After Hospitalization

Even after discharge from the hospital, individuals with inflammatory bowel disease (IBD) remain at risk for developing venous thromboembolism (VTE), according to results of a new study. From these findings, the study’s researchers developed a care predictive model to determine which patients may benefit from extended thromboprophylaxis.

Using a retrospective observational design, the researchers evaluated the incidence of and risk for VTE among individuals with IBD hospitalized between January 1, 2009, and December 31, 2016, at The Ottawa Hospital in Ontario, Canada.

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Among 2161 discharges, 66 (3.1%) were associated with VTE within 6 months of discharge. The median time to VTE was 37 days. Multiple admissions within 3 months and age older than 45 years were both independently associated with VTE risk.

To predict VTE risk within 3 months of discharge, a point-of-care model was developed to stratify which discharges were associated with VTE. Variables assessed in the model included age greater than 45 years, multiple admissions, intensive-care unit admission, admission longer than 7 days, and central catheter placement.

By limiting treatment to a high‐risk group, extended thromboprophylaxis could be avoided in 92% of discharges with a miss rate of 1.6% (32/1982 discharges).

“Our clinical predictive score is simple to use and incorporates clinical variables that would be readily available for all patients at discharge,” the researchers concluded. “Furthermore, the use of a patient‐specific risk score provides a more rational basis for determining when extended thromboprophylaxis should be considered.”

—Colleen Murphy

Reference:

McCurdy JD, Israel A, Hasan M, et al. A clinical predictive model for post‐hospitalisation venous thromboembolism in patients with inflammatory bowel disease [published online May 8, 2019]. Aliment Pharmacol Ther. doi:10.1111/apt.15286.