Intestinal Research

Original Article

IBD

Risk of venous thromboembolism with a central venous catheter in hospitalized Japanese patients with inflammatory bowel disease: a propensity score-matched cohort study: Yasuhiro Aoki, Hiroki Kiyohara, Yohei Mikami, Kosaku Nanki, Takaaki Kawaguchi, Yusuke Yoshimatsu, Shinya Sugimoto, Tomohisa Sujino, Kaoru Takabayashi, Naoki Hosoe, Haruhiko Ogata, Yasushi Iwao, Takanori Kanai; Intest Res 2023;21(3):318-327. Published online February 10, 2023; DOI: https://doi.org/10.5217/ir.2022.00116

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Background/Aims
Thromboprophylaxis is recommended for hospitalized patients with inflammatory bowel disease (IBD) in Western countries, although it is selectively administered to high-risk patients in East Asia. A central venous catheter (CVC) is commonly placed in patients with IBD. Although CVC placement is considered a risk factor for venous thromboembolism (VTE), the degree of increased risk in patients with IBD is uncertain. This study aimed to identify the risk of VTE with CVC placement in hospitalized Japanese patients with IBD without thromboprophylaxis.
Methods
This retrospective cohort study included patients with ulcerative colitis or Crohn’s disease who were admitted for disease flares at Keio University Hospital between January 2016 and December 2020. Patients who already had thrombosis or were administered any antithrombotic treatment on admission were excluded. VTE development during the hospitalization was surveyed, and VTE risk associated with CVC indwelling was estimated using propensity score matching and inverse probability of treatment weighting analyses.
Results
Altogether, 497 hospitalized patients with IBD (ulcerative colitis, 327; Crohn’s disease, 170) were enrolled. VTE developed in 9.30% (12/129) of catheterized patients and in 0.82% (3/368) of non-catheterized patients. The propensity score matching yielded 127 matched pairs of patients. The catheterized group demonstrated higher odds for VTE than the non-catheterized group (odds ratio, 13.15; 95% confidence interval, 1.68–102.70). A similar result was obtained in the inverse probability of treatment weighting analysis (odds ratio, 11.02; 95% confidence interval, 2.64–46.10).
Conclusions
CVC placement is a major risk factor for VTE among hospitalized Japanese patients with IBD without thromboprophylaxis.

Citations

Citations to this article as recorded by

Incidence of Venous Thromboembolism in Asian Patients With Inflammatory Bowel Disease: A Systematic Review and Meta‐Analysis
Joo Hye Song, Sung Ryul Shim, Dae Sung Kim, Hoon Sup Koo, Kyu Chan Huh
Journal of Gastroenterology and Hepatology.2025; 40(4): 774. CrossRef
Metabolic Disorders and Inflammatory Bowel Diseases
Hye Kyung Hyun, Jae Hee Cheon
Gut and Liver.2025; 19(3): 307. CrossRef
Safety and effectiveness of tofacitinib in Korean adult patients with ulcerative colitis: post-marketing surveillance study
Hyuk Yoon, Byong Duk Ye, Sang-Bum Kang, Kang-Moon Lee, Chang Hwan Choi, Joo-young Jo, Juwon Woo, Jae Hee Cheon
BMC Gastroenterology.2024;[Epub] CrossRef

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Case Report

Inflammatory bowel diseases

Inflammatory bowel disease and superior mesenteric artery thromboembolism: Steven Nicolaides, Abhinav Vasudevan, Daniel Van Langenberg; Intest Res 2020;18(1):130-133. Published online September 3, 2019; DOI: https://doi.org/10.5217/ir.2019.00068

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While patients with inflammatory bowel disease are known to be at increased risk of venous thromboembolism, the risk of arterial thrombosis is less well recognized. Here, we describe the case of a middle-aged female with a recent diagnosis of Crohn’s disease who presented to her local emergency department with acute abdominal pain. Subsequent investigations revealed a thrombus in the superior mesenteric artery resulting in multi-organ infarction requiring major intra-abdominal surgery and extensive resection of segments of small and large bowel.

Citations

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Etiology and Risk Factors for Splanchnic Vein Thrombosis in Non-Cirrhotic, Non-Neoplastic Patients: A Narrative Review
Mihaela Hostiuc, Ionut Negoi
Medicina.2025; 61(5): 933. CrossRef
Navigating the Gut-Cardiac Axis: Understanding Cardiovascular Complications in Inflammatory Bowel Disease
Tanya Sinha, Zukhruf Zain, Syed Faqeer Hussain Bokhari, Sarosh Waheed, Taufiqa Reza, Anthony Eze-Odurukwe, Mitwa Patel, Mohammed Khaleel I KH Almadhoun , Azlaan Hussain, Ibrahim Reyaz
Cureus.2024;[Epub] CrossRef
Microscopic Colitis: An Underestimated Disease of Growing Importance
Kamil Rutkowski, Karina Udrycka, Barbara Włodarczyk, Ewa Małecka-Wojciesko
Journal of Clinical Medicine.2024; 13(19): 5683. CrossRef
Venous Thromboembolism Risk in Asian Patients with Inflammatory Bowel Disease: A Population-Based Nationwide Inception Cohort Study
Su Young Kim, Yeon Seo Cho, Hyun-Soo Kim, Jung Kuk Lee, Hee Man Kim, Hong Jun Park, Hyunil Kim, Jihoon Kim, Dae Ryong Kang
Gut and Liver.2022; 16(4): 555. CrossRef
Thromboembolic Events in Patients with Inflammatory Bowel Disease: A Comprehensive Overview
Dhir Gala, Taylor Newsome, Nicole Roberson, Soo Min Lee, Marvel Thekkanal, Mili Shah, Vikash Kumar, Praneeth Bandaru, Vijay Gayam
Diseases.2022; 10(4): 73. CrossRef

7,502 View
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5 Crossref

Original Articles

IBD

Hypoalbuminemia as a risk factor for thromboembolic events in inflammatory bowel disease inpatients: Marcello Rabello Imbrizi, Daniela Oliveira Magro, Tirzah de Mendonça Lopes Secundo, Marlone Cunha-Silva, Paulo Gustavo Kotze, Ciro Garcia Montes, Jazon Romilson de Souza Almeida, Virgínia Lúcia Ribeiro Cabral; Intest Res 2019;17(1):63-69. Published online January 25, 2019; DOI: https://doi.org/10.5217/ir.2018.00077

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Background/Aims
Inflammatory bowel disease (IBD) are chronic entities characterized by local and systemic inflammation and may be associated with thrombosis. The aim of this study was to identify the prevalence of thromboembolic events (TEE) in hospitalized IBD patients and identify risk factors for their occurrence.
Methods
This retrospective, single-center study included patients treated at a Brazilian IBD referral unit between 2004 and 2014. Patients hospitalized for more than 48 hours due to active IBD and who did not receive prophylaxis for TEE during hospitalization were included. Patients were allocated to 2 groups: those with TEE up to 30 days or at the time of hospitalization (TEE-group) and patients without TEE (control-group). Clinical and laboratory characteristics were evaluated.
Results
Of 53 patients evaluated, 69,8% with Crohn’s disease (CD) and 30.2% with ulcerative colitis (UC). The prevalence of TEE 30 days before or during hospitalization was 15.1%, with 10.8% in CD and 25% in UC. In the TEE group, mean serum albumin was 2.06 g/dL versus 3.30 g/dL in the control group. Patients with albumin levels below 2.95 g/dL (43.18%) had a higher risk of developing TEE (relative risk, 1.72; 95% confidence interval, 1.17–2.53) (P<0.001).
Conclusions
Albumin levels were significantly lower in patients with TEE, and hypoalbuminemia was considered a risk factor for the development of TEE in this population.

Citations

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World Journal of Clinical Cases.2024; 12(4): 746. CrossRef
Risk of venous thromboembolism with a central venous catheter in hospitalized Japanese patients with inflammatory bowel disease: a propensity score-matched cohort study
Yasuhiro Aoki, Hiroki Kiyohara, Yohei Mikami, Kosaku Nanki, Takaaki Kawaguchi, Yusuke Yoshimatsu, Shinya Sugimoto, Tomohisa Sujino, Kaoru Takabayashi, Naoki Hosoe, Haruhiko Ogata, Yasushi Iwao, Takanori Kanai
Intestinal Research.2023; 21(3): 318. CrossRef
Predictors of Deep Venous Thrombosis in Hospitalized Patients With Liver Cirrhosis in the US
Ahmad Abou Yassine, Mohammad Abureesh, Rachelle Hamadi, Loai Dahabra, Mohammad Alshami, Deeb Liliane
Cureus.2022;[Epub] CrossRef
Venous Thromboembolism Risk in Asian Patients with Inflammatory Bowel Disease: A Population-Based Nationwide Inception Cohort Study
Su Young Kim, Yeon Seo Cho, Hyun-Soo Kim, Jung Kuk Lee, Hee Man Kim, Hong Jun Park, Hyunil Kim, Jihoon Kim, Dae Ryong Kang
Gut and Liver.2022; 16(4): 555. CrossRef
Thromboembolism is associated with poor prognosis and high mortality in patients with inflammatory bowel disease: A case–control study
Yadukrishna S., Saurabh Kedia, Varun Teja, Sudheer Kumar Vuyyuru, Nidhi Yadav, Pabitra Sahu, Saransh Jain, Dawesh P. Yadav, Sawan Bopanna, Venigalla Pratap Mouli, Deepak Madhu, Raju Sharma, Prasenjit Das, Govind Makharia, Vineet Ahuja
Indian Journal of Gastroenterology.2022;[Epub] CrossRef
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Sara A. Jablonski Wennogle, Christine S. Olver, Sarah B. Shropshire
Journal of Veterinary Internal Medicine.2021; 35(2): 892. CrossRef
Hypoalbuminemia: a risk factor in patients with STEC-associated hemolytic uremic syndrome
Carlos J. Cobeñas, Laura L. Lombardi, Priscila Pereyra, Emanuel De Rose, María José Gogorza, Ana Paula Spizzirri, Javier D. Ruscasso, Soledad Luján Ferradas, Ángela del Carmen Suárez, Oscar R. Amoreo, Javier H. Zalba, Paula Risso
Pediatric Nephrology.2021; 36(9): 2739. CrossRef
A Conceptual Framework for Rescheduling Elective Pediatric Gastroenterology Procedures Following COVID-19 Pandemic Lockdown
Panamdeep Kaur, Thomas M. Attard, Douglas S. Fishman, Fernando Zapata, Donna Ditsch, Mike Thomson, Jennifer V. Schurman
Gastroenterology Nursing.2020; 43(5): 375. CrossRef
SURGICAL STRATEGIES IN MULTIDISCIPLINARY MANAGEMENT OF CROHN'S DISEASE
Claudio Saddy Rodrigues Coy, Paulo Gustavo Kotze
Revista Médica Clínica Las Condes.2019; 30(5): 349. CrossRef

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180 Download
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IBD

The incidence and risk factors of venous thromboembolism in Japanese inpatients with inflammatory bowel disease: a retrospective cohort study: Katsuyoshi Ando, Mikihiro Fujiya, Yoshiki Nomura, Yuhei Inaba, Yuuya Sugiyama, Takuya Iwama, Masami Ijiri, Keitaro Takahashi, Kazuyuki Tanaka, Aki Sakatani, Nobuhiro Ueno, Shin Kashima, Kentaro Moriichi, Yusuke Mizukami, Toshikatsu Okumura; Intest Res 2018;16(3):416-425. Published online July 27, 2018; DOI: https://doi.org/10.5217/ir.2018.16.3.416

Abstract PDF PubReader ePub

<b>Background/Aims</b><br/>

Venous thromboembolism (VTE) is a major extraintestinal manifestation in inflammatory bowel disease (IBD), regarded as an independent risk factor for VTE according to reports from Western countries. However, the incidence and risk factors of VTE in Asian IBD patients are not fully understood. We aimed to reveal the incidence and risk factors of VTE in Japanese IBD inpatients.

Methods

The incidence of VTE in inpatients with IBD (n=340), gastrointestinal cancers (n=557), and other gastrointestinal diseases (n=569) treated at our hospital from 2009 to 2013 was retrospectively investigated. The characteristics and laboratory data of IBD inpatients with and without VTE were compared in univariate and multivariate analyses. Clinical courses of VTE in IBD were surveyed.

Results

VTE was detected in 7.1% of IBD inpatients, significantly higher than in gastrointestinal cancer inpatients (2.5%) and inpatients with other gastrointestinal diseases (0.88%). The incidence of VTE in ulcerative colitis (UC) patients (16.7%) was much higher than that in those with Crohn's disease (3.6%). In the univariate analysis, the risk factors were an older age, central venous catheter, prednisolone, surgery, low serum albumin, high serum C-reactive protein and D-dimer. According to a multivariate analysis, >50 years of age and surgery were the only risk factors. The in-hospital mortality rate of IBD inpatients with VTE was 4.2%.

Conclusions

The incidence of VTE with IBD, especially UC, was found to be high compared with other digestive disease, which was almost equivalent to that of Western countries. The efficacy of prophylaxis needs to be investigated in Asian IBD patients.

Citations

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P Krishna Bharadwaj, Ebby George Simon, Rutvi G Dave, Tulasi Geevar, Sukesh C Nair, Joseph AJ, Amit Kumar Dutta, Rajeeb Jaleel, Anoop John, Ajith Thomas, Amith Viswanath
Indian Journal of Gastroenterology.2025;[Epub] CrossRef
Venous and arterial thromboembolism in out-patients with inflammatory bowel disease: a single center study.
Antonella Tufano, Anna Testa, Marta Patturelli, Antonio Rispo, Vincenzo Fotticchia, Paola Rufolo, Federica Strano, Alessia Dalila Guarino, Antonietta Vitale, Olga Maria Nardone, Mario Ferrante, Rossella Caso, Fabiana Castiglione
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Journal of Crohn's and Colitis.2024; 18(5): 773. CrossRef
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Francisco A. Guzman-Pruneda, Ambar Garcia, Robert W. Crum, Theresa Chen, Abraham Krikhely, Marc Bessler
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Wan Feng, Lei Zhu, Song Zhao, Kai Zheng, Luzhou Xu, Hong Shen
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Seminars in Thrombosis and Hemostasis.2023; 49(07): 744. CrossRef
Risk of venous thromboembolism with a central venous catheter in hospitalized Japanese patients with inflammatory bowel disease: a propensity score-matched cohort study
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Case Report

IBD

A case of ulcerative colitis presenting with cerebral venous thrombosis: Junghwan Lee, Sung Wook Hwang, Jinhee Lee, Kyung Hwa Jung, Ha Il Kim, Sang Hyoung Park, Dong-Hoon Yang, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang; Intest Res 2018;16(2):306-311. Published online April 30, 2018; DOI: https://doi.org/10.5217/ir.2018.16.2.306

Abstract PDF PubReader ePub

Patients with inflammatory bowel disease (IBD) have been reported to have an increased risk of thromboembolism. Cerebral venous thrombosis (CVT) is a rare but serious extraintestinal manifestation of IBD. Due to its highly variable manifestation and low incidence, CVT is not usually readily recognized by physicians. Herein, we report a case of a 35-year-old male presenting with CVT associated with ulcerative colitis (UC). The patient was admitted with chief complaints of bloody diarrhea that had started 3 days prior. Sigmoidoscopy showed hyperemic and edematous mucosa, friability, and shallow ulcers from the sigmoid colon to the rectum suggestive of IBD. Three days later, the patient started complaining of a headache, and gradually developed a decreased level of consciousness. Magnetic resonance imaging of the brain revealed CVT with hemorrhagic infarctions. An angiogram was obtained to evaluate the extent of CVT, and anticoagulation therapy was initiated with intravenous heparin. During hospitalization, he was diagnosed with UC and treated with 5-aminosalicylic acid. After discharge, the patient was recovered without neurological deficit, and remission of UC was also obtained. The presence of headache or acute worsening of neurological status in a patient with IBD should alert the health professionals about the possibility of CVT.

Citations

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Digit Necrosis After Hand Surgery in Pregnancy: A Case Report
Natalia Ziolkowski, Jana Dengler, Cory S Goldberg
Plastic Surgery Case Studies.2021;[Epub] CrossRef
Cerebral venous thrombosis as presenting manifestation of inflammatory bowel disease (IBD)
Katie Stamp, Alison Pattinson, Paul Maliakal, Thekootu Nandakumar, Shaji Sebastian
GastroHep.2019; 1(1): 45. CrossRef

8,289 View
104 Download
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