Inflammatory bowel disease increases the risks of deep vein thrombosis and pulmonary embolism in the hospitalized patients: a nationwide cohort study

Wei-Sheng Chung; Cheng-Li Lin; Wu-Huei Hsu; Chia-Hung Kao

doi:10.1016/j.thromres.2014.12.025

Inflammatory bowel disease increases the risks of deep vein thrombosis and pulmonary embolism in the hospitalized patients: a nationwide cohort study

Thromb Res. 2015 Mar;135(3):492-6. doi: 10.1016/j.thromres.2014.12.025. Epub 2015 Jan 7.

Authors

Wei-Sheng Chung¹, Cheng-Li Lin², Wu-Huei Hsu³, Chia-Hung Kao⁴

Affiliations

¹ Department of Internal Medicine, Taichung Hospital, Ministry of Health and Welfare, Taichung, Taiwan; Department of Health Services Administration, China Medical University, Taichung, Taiwan; Department of Healthcare Administration, Central Taiwan University of Science and Technology, Taichung, Taiwan.
² Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan; Department of Public Health, China Medical University, Taichung, Taiwan.
³ Department of Respiratory and Critical Care, China Medical University Hospital, Taichung, Taiwan; Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan.
⁴ Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan; Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan. Electronic address: d10040@mail.cmuh.org.tw.

PMID: 25596768
DOI: 10.1016/j.thromres.2014.12.025

Abstract

Background & aims: We conducted a nationwide, population-based cohort study to evaluate the effects of inflammatory bowel disease (IBD) on the risks of developing deep vein thrombosis (DVT) and pulmonary embolism (PE) in Taiwan.

Methods: We randomly selected the study cohort with IBD from the National Health Insurance (NHI) database (N = 23.74 million) and the control cohort without IBD who was frequency-matched the study cohort based on age, sex, and index year to each IBD patient between 2000 and 2010. Using a follow-up period ending in 2011, we analyzed the risks of DVT and PE using Cox proportional hazard regression analyses.

Results: The 11 445 IBD patients and 45 780 controls were followed 65 256 and 293 377 person-years, respectively. After adjusting for age, sex, and comorbidities, the risks of IBD patients developing DVT and PE was 1.98-fold and 1.80-fold higher, respectively, than those of the comparison cohort. The IBD patients presenting with 2 or more annual hospitalizations exhibited a significantly greater risk of developing DVT (adjusted hazard ratio [HR] 32.9, 95% confidence interval [CI] 20.5-52.8) and PE (adjusted HR = 24.2, 95% CI = 11.1-52.9) than did the comparison cohort. Women with IBD showed a significantly greater risk of DVT and PE than did the comparison cohort (adjusted HR = 1.80, 95% CI = 1.18-2.78 for DVT and adjusted HR=2.08, 95% CI = 1.14-3.80 for PE respectively).

Conclusion: The risks of DVT and PE are significantly higher in IBD patients compared with risks in the general population.

What is current knowledge: Thromboembolic complications are easily overlooked in IBD patients.

What is new here: The risks of DVT and PE are significantly higher in IBD patients.

Keywords: Deep vein thrombosis (DVT); Inflammatory bowel disease (IBD); National Health Insurance (NHI); Pulmonary embolism (PE).

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Aged
Cohort Studies
Comorbidity
Female
Hospitalization
Humans
Incidence
Inflammatory Bowel Diseases / complications*
Male
Middle Aged
Pulmonary Embolism / etiology*
Risk
Risk Factors
Venous Thrombosis / etiology*
Young Adult