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VTE risk low among patients hospitalized with IBD

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Most hospitalized patients with inflammatory bowel disease have a low risk for venous thromboembolism and, therefore, pharmacologic prophylaxis is likely unnecessary, according to research presented at the Society of Hospital Medicine Annual Meeting.

Guidelines recommend pharmacologic prophylaxis for venous thromboembolism (VTE) in patients hospitalized with an acute IBD exacerbation, and according to performance quality measures, patients with IBD who are hospitalized for any reason should receive prophylaxis, David Paje, MD, from the University of Michigan Health System, Ann Arbor, and colleagues wrote.

The research team used a representative sample of 78,794 hospitalized medical patients discharged between December 2011 and June 2015, 3% of whom had IBD and 1.1% of whom had an acute IBD exacerbation, to determine the risk for VTE in hospitalized patients with IBD using the Padua prediction score.

Overall, there were 11 (0.5%; 95% CI, 0.2-0.8) VTE events among all patients with IBD, and four (0.5%; 95% CI, 0.1-1.2) VTE events among patients with an acute IBD exacerbation.

Of the patients with IBD, 88.8% were considered to be at low risk for VTE, and of the patients with an acute IBD exacerbation, 96.1% were considered to be at low risk for VTE.

The rate of VTE was 0.3% for low-risk patients with IBD and 1.5% for those at high risk (P = .03). Moreover, the rate of VTE was 0.4% for low-risk patients with IBD who received pharmacologic or mechanical prophylaxis vs. 1.7% for high-risk patients with IBD who received any prophylaxis (P = .03).

The researchers concluded that the rate of VTE events is low in hospitalized patients with IBD and IBD acute exacerbation, and that based on the Padua prediction score, most are at low risk and probably do not need VTE prophylaxis. Quality measures that require VTE prophylaxis for patients with IBD, thus, should be reconsidered, they added. – by Adam Leitenberger 

Reference:

Paje D, et al. Abstract 255. Presented at: SHM Annual Meeting; March 6-9, 2016; San Diego.

Disclosure: Healio Gastroenterology was unable to confirm relevant financial disclosures at the time of publication.