Meng-Tzu Weng1,2,3, Sang Hyoung Park4, Katsuyoshi Matsuoka5, Chien-Chih Tung1, Jae Yong Lee4, Chin-Hao Chang6, Suk-Kyun Yang4, Mamoru Watanabe5, Jau-Min Wong1, Shu-Chen Wei1. 1. Departments of Internal Medicine, National Taiwan University Hospital, Taipei City, Taiwan. 2. Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City Taiwan. 3. Department of Chemical Engineering & Materials Science, Yuan-Ze University, Taoyuan, Taiwan. 4. Department of Gastroenterology and Inflammatory Bowel Disease Center, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea. 5. Department of Gastroenterology and Hepatology, Tokyo Medical and Dental University, Tokyo, Japan. 6. Departments of Medical Research, National Taiwan University Hospital, Taipei City, Taiwan.
Abstract
Background: Inflammatory bowel disease (IBD) increases the risk of venous thromboembolism (VTE) events. However, the incidence and necessity of prophylaxis for VTE in Asian IBD patients is unknown. We examined the incidence of VTE in East Asian IBD patients and analyze the possible risk factors. Methods: We conducted a multinational retrospective study of 2562 hospitalized IBD patients from 2010 to 2015. Moreover, a nationwide cohort study from 2001 to 2013 from the Taiwan National Health Insurance Research Database (NHIRD) was conducted to analyze the incidence rate of VTE in IBD and non-IBD patients. Results: In the hospitalized cohort, 24 IBD patients [17 ulcerative colitis (UC) and 7 Crohn's disease (CD)] received a VTE diagnosis (0.9%). These patients had a higher proportion of extensive UC (P = 0.04), penetrating-type CD (P < 0.01), and bowel operation history (P = 0.01). VTE was associated with low hemoglobin (P < 0.01), low platelet (P < 0.01), and low albumin (P < 0.01) levels. For the nation-wide cohort study, 3178 IBD patients and 31,780 age- and sex-matched non-IBD patients were analyzed. The average incidence rate was 1.15 per 1000 person-years in the IBD cohort and 0.51 in the non-IBD cohort. The relative risk was 2.27 (95% CI, 1.99-2.60). Conclusions: East Asian IBD patients carry a 2-fold increased risk of VTE than the general population. The incidence of VTE in the East Asian IBD patients is still lower than that in Western countries. Therefore, close monitoring rather than routine prophylaxis of VTE in East Asian IBD patients is recommended.
Background: Inflammatory bowel disease (IBD) increases the risk of venous thromboembolism (VTE) events. However, the incidence and necessity of prophylaxis for VTE in Asian IBDpatients is unknown. We examined the incidence of VTE in East Asian IBDpatients and analyze the possible risk factors. Methods: We conducted a multinational retrospective study of 2562 hospitalized IBDpatients from 2010 to 2015. Moreover, a nationwide cohort study from 2001 to 2013 from the Taiwan National Health Insurance Research Database (NHIRD) was conducted to analyze the incidence rate of VTE in IBD and non-IBDpatients. Results: In the hospitalized cohort, 24 IBDpatients [17 ulcerative colitis (UC) and 7 Crohn's disease (CD)] received a VTE diagnosis (0.9%). These patients had a higher proportion of extensive UC (P = 0.04), penetrating-type CD (P < 0.01), and bowel operation history (P = 0.01). VTE was associated with low hemoglobin (P < 0.01), low platelet (P < 0.01), and low albumin (P < 0.01) levels. For the nation-wide cohort study, 3178 IBDpatients and 31,780 age- and sex-matched non-IBDpatients were analyzed. The average incidence rate was 1.15 per 1000 person-years in the IBD cohort and 0.51 in the non-IBD cohort. The relative risk was 2.27 (95% CI, 1.99-2.60). Conclusions: East Asian IBDpatients carry a 2-fold increased risk of VTE than the general population. The incidence of VTE in the East Asian IBDpatients is still lower than that in Western countries. Therefore, close monitoring rather than routine prophylaxis of VTE in East Asian IBDpatients is recommended.
Authors: Pablo A Olivera; Stephane Zuily; Paulo G Kotze; Veronique Regnault; Sameer Al Awadhi; Peter Bossuyt; Richard B Gearry; Subrata Ghosh; Taku Kobayashi; Patrick Lacolley; Edouard Louis; Fernando Magro; Siew C Ng; Alfredo Papa; Tim Raine; Fabio V Teixeira; David T Rubin; Silvio Danese; Laurent Peyrin-Biroulet Journal: Nat Rev Gastroenterol Hepatol Date: 2021-08-27 Impact factor: 46.802
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