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Outpatient VTE linked with age, C. diff, discharge after IBD hospitalizations
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Patients with inflammatory bowel disease are at increased risk for venous thromboembolism for up two months after discharge from the hospital, according to study results.
“Patients with inflammatory bowel disease have an increased risk of venous thromboembolism [VTE], especially during hospitalization,” Adam S. Faye, MD, of the division of gastroenterology at Columbia University Medical Center, told Healio Gastroenterology and Liver Disease. “Recent data has suggested that this increased risk may extend for several weeks post-discharge. As such, our study within the Nationwide Readmissions Database looked to assess the timeline, as well as risk factors associated with a VTE readmission event among hospitalized patients with IBD.”
Of 872,122 total index admissions among patients with IBD from 2010 through 2014 included in the database, Faye and colleagues identified 1,160 that resulted in readmission with VTE.
Risk for VTE readmission was highest in the first 10 days after index hospitalization discharge and decreased in each ensuing 10-day period. Investigators found that 91% of these readmissions for VTE occur within the first 60 days of discharge.
Faye and colleagues determined that prior VTE, longer length of hospital stay, comorbidities, having flexible sigmoidoscopy or colonoscopy at index hospitalization and age older than 18 years were associated with hospital readmission for VTE.
Additionally, they found that Clostridioides difficile infection at index admission (adjusted RR = 1.47; 95% CI, 1.17–1.85), as well as discharge to a skilled nursing facility or intermediate care facility (aRR = 1.39; 95% CI, 1.14–1.85) or discharge with home health services (aRR = 1.65; 95% CI, 1.41–1.94) were also risk factors for readmission.
“Given increased thrombotic risk post-discharge, as well as overall safety of VTE prophylaxis, extending pharmacologic VTE prophylaxis for IBD patients at highest risk may have significant benefits in preventing a VTE related readmission,” Faye said. “This, however, must be weighed against the risk of polypharmacy, insurance barriers to implementation, and overall cost, and should be evaluated through future prospective and cost-effectiveness studies.” – by Alex Young
Disclosures: The authors report no relevant financial disclosures.
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