Venous thromboembolic events in inflammatory bowel diseases: A review of current evidence and guidance on risk in the post-hospitalization setting

Thromb Res. 2020 Oct:194:26-32. doi: 10.1016/j.thromres.2020.06.005. Epub 2020 Jun 3.

Abstract

Venous thromboembolism (VTE) is a life-threatening, yet potentially preventable, complication of inflammatory bowel disease (IBD). The incidence of VTE in IBD is roughly three-fold greater than in the general population, and results in a 2-fold increased risk of mortality. The absolute risk is highest during hospitalization and has led to consensus guidelines recommending thromboprophylaxis for all admitted patients with IBD in the absence of contraindications. Emerging evidence suggests that the risk of VTE is likely to remain high early after hospital discharge. Despite this, it remains unclear if thromboprophylaxis should be continued after hospitalization. Therefore, this review will synthesize the available literature pertaining to the post-discharge setting with a focus on the incidence of VTE, associated risk factors, and the potential role for extended thromboprophylaxis.

Keywords: Crohn's disease; Inflammatory bowel disease; Prophylaxis; Thrombosis; Ulcerative colitis.

Publication types

  • Review

MeSH terms

  • Aftercare
  • Anticoagulants / therapeutic use
  • Hospitalization
  • Humans
  • Inflammatory Bowel Diseases* / complications
  • Inflammatory Bowel Diseases* / drug therapy
  • Patient Discharge
  • Risk Factors
  • Venous Thromboembolism* / epidemiology
  • Venous Thromboembolism* / etiology
  • Venous Thromboembolism* / prevention & control

Substances

  • Anticoagulants