Comparison of a novel predictor of venous thromboembolic complications in inflammatory bowel disease with current predictors

J Gastroenterol Hepatol. 2019 May;34(5):870-879. doi: 10.1111/jgh.14472. Epub 2018 Oct 22.

Abstract

Background and aim: Venous thromboembolism (VTE) is a common complication of inflammatory bowel disease (IBD). The aim of the present study was to identify predictors of VTE in hospitalized patients with IBD.

Methods: Patients with IBD who were hospitalized from February 2015 to March 2016 at the Chiba University Hospital were included. VTE was detected using enhanced computed tomography, and VTE onset within 2 months after admission was assessed. Predictors of VTE onset were investigated with clinical factors during hospitalization. Availability of the Caprini risk assessment model and Padua prediction score at the time of admission was also assessed.

Results: Seventy-two patients with IBD were hospitalized, and central venous catheters were placed in 43 of the 72 patients. During the observation period, VTE occurred in six patients (8.3%); however, none died as a result of the condition. Cox proportional hazards regression analysis identified D-dimer values on admission as a risk factor that was highly associated with VTE onset (hazard ratio = 1.590; 95% confidence interval, 1.132-2.233; P = 0.007) and significantly predicted the occurrence of VTE using the receiver operating characteristic curve (P = 0.005, area under the curve = 0.893). However, Caprini risk assessment model and Padua prediction scores were not useful tools for predicting VTE onset in patients with IBD.

Conclusion: In hospitalized patients with IBD, D-dimer values were highly associated with VTE onset. Therefore, measurement of D-dimer values on admission is critical for the management of thromboembolic complications in patients with IBD.

Keywords: Caprini risk assessment model; D-dimer; Padua prediction score; inflammatory bowel disease; predictor; venous thromboembolism.

MeSH terms

  • Adult
  • Biomarkers / blood
  • Female
  • Fibrin Fibrinogen Degradation Products / metabolism
  • Forecasting
  • Hospitalization
  • Humans
  • Inflammatory Bowel Diseases / complications*
  • Male
  • Middle Aged
  • ROC Curve
  • Risk Assessment / methods
  • Risk Factors
  • Tomography, X-Ray Computed
  • Venous Thromboembolism / diagnosis*
  • Venous Thromboembolism / epidemiology
  • Venous Thromboembolism / etiology*
  • Young Adult

Substances

  • Biomarkers
  • Fibrin Fibrinogen Degradation Products
  • fibrin fragment D