Does CVC placement increase the risk of venous thromboembolism in hospitalized IBD patients without pharmacological prophylactic antithrombotic therapy?

Published online August 3, 2023.

Risk of venous thromboembolism with a central venous catheter in hospitalized Japanese patients with inflammatory bowel disease: a propensity score-matched cohort study

Yasuhiro Aoki, Hiroki Kiyohara, Yohei Mikami, Kosaku Nanki, Takaaki Kawaguchi, Yusuke Yoshimatsu, Shinya Sugimoto, Tomohisa Sujino, Kaoru Takabayashi, Naoki Hosoe, Haruhiko Ogata, Yasushi Iwao, Takanori Kanai

Intest Res. 2023;21(3):318-327

Thrombosis is a major complication in patients with inflammatory bowel disease (IBD), and these patients have an approximately 2 to 3 times higher risk of developing venous thromboembolism (VTE) than the general population. While Western clinical guidelines strongly recommended prophylactic antithrombotic therapy for all hospitalized IBD patients, routine prophylactic antithrombotic therapy is controversial in Asian countries. According to a nationwide study in Japan, the incidence of VTE in IBD patients (1.03%, 102.5 per 100,000 IBD person-years) was lower than that in Western countries, but cannot be ignored.

The present study investigated the risk of VTE development with a focus on CVC placement in hospitalized IBD patients who had not received pharmacological prophylactic antithrombotic therapy in Japan. The incidence of VTE development during hospitalization was investigated, and the risk of VTE associated with CVC indwelling was estimated using propensity score matching and inverse probability of treatment weighting analyses.

In this study, the overall incidence of VTE development was 3.02% (15/497), and the overall incidence rate was 1.73 per 1,000 person-days during hospitalization.
VTE developed more frequently in patients with catheterization (9.30%) than in patients without catheterization (0.82%).
The catheterized group had a higher chance of VTE than the non-catheterized group (OR, 13.15; 95% CI, 1.68–102.70; P= 0.014).
Serum albumin level (OR, 0.28; 95% CI, 0.12–0.63; P= 0.002) and hemoglobin level (OR, 0.79; 95% CI, 0.64–0.97; P= 0.027) were associated with a lower chance of VTE. In contrast, CRP level (OR, 1.08; 95% CI, 1.02–1.14; P= 0.010) and platelet level (OR, 1.00; 95% CI, 1.00–1.01; P= 0.025) were associated with higher odds of VTE.

Read more about the risk of VTE with a CVC in Japanese hospitalized patients with IBD.

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