Intest Res 2018; 16(3): 416-425  https://doi.org/10.5217/ir.2018.16.3.416
The incidence and risk factors of venous thromboembolism in Japanese inpatients with inflammatory bowel disease: a retrospective cohort study
Katsuyoshi Ando1*, Mikihiro Fujiya1*, Yoshiki Nomura1, Yuhei Inaba2, Yuuya Sugiyama1, Takuya Iwama1, Masami Ijiri1, Keitaro Takahashi1, Kazuyuki Tanaka1, Aki Sakatani1, Nobuhiro Ueno1, Shin Kashima1, Kentaro Moriichi1, Yusuke Mizukami1, Toshikatsu Okumura1
1Division of Gastroenterology and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, Asahikawa, 2Department of Gastroenterology, Asahikawa City Hospital, Asahikawa, Japan
Correspondence to: Mikihiro Fujiya, Division of Gastroenterology and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, 2-1 Midorigaoka-higashi, Asahikawa 078-8510, Japan. Tel: +81-166-68-2462, Fax: +81-166-68-2469, E-mail: fjym@asahikawa-med.ac.jp
*These authors contributed equally to this study
Received: October 7, 2017; Revised: January 2, 2018; Accepted: January 3, 2018; Published online: July 11, 2018.
© Korean Association for the Study of Intestinal Diseases. All rights reserved.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background/Aims: Venous thromboembolism (VTE) is a major extraintestinal manifestation in inflammatory bowel disease (IBD), regarded as an independent risk factor for VTE according to reports from Western countries. However, the incidence and risk factors of VTE in Asian IBD patients are not fully understood. We aimed to reveal the incidence and risk factors of VTE in Japanese IBD inpatients. Methods: The incidence of VTE in inpatients with IBD (n=340), gastrointestinal cancers (n=557), and other gastrointestinal diseases (n=569) treated at our hospital from 2009 to 2013 was retrospectively investigated. The characteristics and laboratory data of IBD inpatients with and without VTE were compared in univariate and multivariate analyses. Clinical courses of VTE in IBD were surveyed. Results: VTE was detected in 7.1% of IBD inpatients, significantly higher than in gastrointestinal cancer inpatients (2.5%) and inpatients with other gastrointestinal diseases (0.88%). The incidence of VTE in ulcerative colitis (UC) patients (16.7%) was much higher than that in those with Crohn’s disease (3.6%). In the univariate analysis, the risk factors were an older age, central venous catheter, prednisolone, surgery, low serum albumin, high serum C-reactive protein and D-dimer. According to a multivariate analysis, >50 years of age and surgery were the only risk factors. The in-hospital mortality rate of IBD inpatients with VTE was 4.2%. Conclusions: The incidence of VTE with IBD, especially UC, was found to be high compared with other digestive disease, which was almost equivalent to that of Western countries. The efficacy of prophylaxis needs to be investigated in Asian IBD patients.
Keywords: Venous thromboembolism; Inflammatory bowel disease; Risk factors


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