Patients admitted to the hospital with active inflammatory bowel disease (IBD) are at an increased risk of thromboembolism. Surgical specialties suggest that thromboembolism prophylaxis is advantageous after hospital discharge in high-risk groups. A recent study attempted to identify IBD patients at increased risk of thromboembolism and developed a scoring system to recognize them. Hospital episode statistics data was utilized to identify all patients admitted for IBD emergently or electively for surgery. All the patients with thromboembolism within 90 days of hospital discharge were also identified. A multilevel logistic regression model identified patient and admission level factors associated with increased risk of thromboembolism, which was used to create a scoring system to identify higher-risk patients. The study included 201,779 admissions in 101,966 patients. Within 90 days, the rate of thromboembolism was found to be 17.24 per 1000 patient-years at risk, which was greatest in patients admitted as an emergency undergoing surgery (36.91) followed by emergency admission without surgery (15.63) and elective admission for surgery (15.60). The rate of thromboembolism between 180 and 270 days following discharge was found to be 0.84, 1.59 and 1.70 per 1000 patient-years at risk respectively.

Female gender, increasing age (49–60 years), increasing length of stay, increasing number of prior admissions for IBD in preceding 3 months, ulcerative colitis and admission type compared to elective surgery showed statistically significant associations. A score ≥9, in the scoring system, provided a positive predictive value of 1%. The AUC was found to be 0.71.Patients admitted to the hospital are at an increased risk of thromboembolism within the 90 days following discharge, which is further increased in patients with prolonged length of stay, increasing age, male gender or admitted as an emergency requiring surgery. The scoring system can identify high-risk patients.

Source: Harvey P, et al. Journal of Crohn′s and Colitis, 2022;16(1):079–i081.