Venous thromboembolism in inflammatory bowel disease

Craig A. Solem, Edward Vincent Loftus, Jr, William J. Tremaine, William J. Sandborn

Research output: Contribution to journalArticle

251 Citations (Scopus)

Abstract

OBJECTIVES: Venous thromboembolism has been associated with inflammatory bowel disease (IBD). We sought to describe the clinical features, acquired and congenital risk factors, and outcomes of venous thromboembolism in IBD. METHODS: All patients with confirmed IBD and deep venous thrombosis (DVT) or pulmonary embolism (PE) at our institution between 1991 and 2000 were identified. Medical records were abstracted for clinical features, risk factors, treatment, and outcomes. RESULTS: Fifty-nine ulcerative colitis (UC) patients (68% males) and 39 Crohn's disease (CD) patients (41% males) were identified. UC extent was pancolonic in 76%, and CD extent was ileocolonic in 56%, colonic in 23%, and ileal in 21%. Eighty percent of CD patients and 79% of UC patients had active disease. Thrombophilia was present in 33% of the 40 patients tested. Most patients (87%) had other risk factors for DVT/PE. Long-term treatment included warfarin alone (62%), warfarin and IVC filter (18%), and IVC filter alone (7%). Five CD patients (13%) had recurrent DVT/PE. Among the 16 UC patients who underwent proctocolectomy following DVT/PE, there were two recurrences (13%), similar to the three recurrences (10%) seen among the 29 patients who had intact colons. Mortality rate was 22% after a median follow-up of 1.8 yr. CONCLUSIONS: Venous thromboembolism is a serious complication of IBD that may lead to death. Thrombophilia evaluations have a relatively high diagnostic yield overall, although specific genetic abnormalities are individually uncommon. Other DVT/PE risk factors are usually present. Proctocolectomy is not protective of recurrent DVT/PE.

Original languageEnglish (US)
Pages (from-to)97-101
Number of pages5
JournalAmerican Journal of Gastroenterology
Volume99
Issue number1
DOIs
StatePublished - Jan 2004

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Venous Thromboembolism
Inflammatory Bowel Diseases
Pulmonary Embolism
Venous Thrombosis
Ulcerative Colitis
Crohn Disease
Thrombophilia
Warfarin
Recurrence
Medical Records
Colon
Mortality

ASJC Scopus subject areas

  • Gastroenterology

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Venous thromboembolism in inflammatory bowel disease. / Solem, Craig A.; Loftus, Jr, Edward Vincent; Tremaine, William J.; Sandborn, William J.

In: American Journal of Gastroenterology, Vol. 99, No. 1, 01.2004, p. 97-101.

Research output: Contribution to journalArticle

Solem, Craig A. ; Loftus, Jr, Edward Vincent ; Tremaine, William J. ; Sandborn, William J. / Venous thromboembolism in inflammatory bowel disease. In: American Journal of Gastroenterology. 2004 ; Vol. 99, No. 1. pp. 97-101.
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abstract = "OBJECTIVES: Venous thromboembolism has been associated with inflammatory bowel disease (IBD). We sought to describe the clinical features, acquired and congenital risk factors, and outcomes of venous thromboembolism in IBD. METHODS: All patients with confirmed IBD and deep venous thrombosis (DVT) or pulmonary embolism (PE) at our institution between 1991 and 2000 were identified. Medical records were abstracted for clinical features, risk factors, treatment, and outcomes. RESULTS: Fifty-nine ulcerative colitis (UC) patients (68{\%} males) and 39 Crohn's disease (CD) patients (41{\%} males) were identified. UC extent was pancolonic in 76{\%}, and CD extent was ileocolonic in 56{\%}, colonic in 23{\%}, and ileal in 21{\%}. Eighty percent of CD patients and 79{\%} of UC patients had active disease. Thrombophilia was present in 33{\%} of the 40 patients tested. Most patients (87{\%}) had other risk factors for DVT/PE. Long-term treatment included warfarin alone (62{\%}), warfarin and IVC filter (18{\%}), and IVC filter alone (7{\%}). Five CD patients (13{\%}) had recurrent DVT/PE. Among the 16 UC patients who underwent proctocolectomy following DVT/PE, there were two recurrences (13{\%}), similar to the three recurrences (10{\%}) seen among the 29 patients who had intact colons. Mortality rate was 22{\%} after a median follow-up of 1.8 yr. CONCLUSIONS: Venous thromboembolism is a serious complication of IBD that may lead to death. Thrombophilia evaluations have a relatively high diagnostic yield overall, although specific genetic abnormalities are individually uncommon. Other DVT/PE risk factors are usually present. Proctocolectomy is not protective of recurrent DVT/PE.",
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AB - OBJECTIVES: Venous thromboembolism has been associated with inflammatory bowel disease (IBD). We sought to describe the clinical features, acquired and congenital risk factors, and outcomes of venous thromboembolism in IBD. METHODS: All patients with confirmed IBD and deep venous thrombosis (DVT) or pulmonary embolism (PE) at our institution between 1991 and 2000 were identified. Medical records were abstracted for clinical features, risk factors, treatment, and outcomes. RESULTS: Fifty-nine ulcerative colitis (UC) patients (68% males) and 39 Crohn's disease (CD) patients (41% males) were identified. UC extent was pancolonic in 76%, and CD extent was ileocolonic in 56%, colonic in 23%, and ileal in 21%. Eighty percent of CD patients and 79% of UC patients had active disease. Thrombophilia was present in 33% of the 40 patients tested. Most patients (87%) had other risk factors for DVT/PE. Long-term treatment included warfarin alone (62%), warfarin and IVC filter (18%), and IVC filter alone (7%). Five CD patients (13%) had recurrent DVT/PE. Among the 16 UC patients who underwent proctocolectomy following DVT/PE, there were two recurrences (13%), similar to the three recurrences (10%) seen among the 29 patients who had intact colons. Mortality rate was 22% after a median follow-up of 1.8 yr. CONCLUSIONS: Venous thromboembolism is a serious complication of IBD that may lead to death. Thrombophilia evaluations have a relatively high diagnostic yield overall, although specific genetic abnormalities are individually uncommon. Other DVT/PE risk factors are usually present. Proctocolectomy is not protective of recurrent DVT/PE.

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