Risk of venous thromboembolism with a central venous catheter in hospitalized Japanese patients with inflammatory bowel disease: a propensity score-matched cohort study.

IF 3.4 Q2 GASTROENTEROLOGY & HEPATOLOGY

Intestinal Research Pub Date : 2023-07-01 DOI:10.5217/ir.2022.00116

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

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引用次数: 0

Abstract

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.

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日本住院炎症性肠病患者中心静脉导管静脉血栓栓塞的风险:一项倾向评分匹配的队列研究

背景/目的:在西方国家，血栓预防被推荐用于炎症性肠病(IBD)住院患者，尽管在东亚，它是选择性地给药给高危患者。中心静脉导管(CVC)通常放置在IBD患者。尽管CVC放置被认为是静脉血栓栓塞(VTE)的危险因素，但IBD患者的风险增加程度尚不确定。本研究旨在确定没有血栓预防的日本IBD住院患者放置CVC发生静脉血栓栓塞的风险。方法:本回顾性队列研究纳入2016年1月至2020年12月在庆应义塾大学医院因疾病发作而入院的溃疡性结肠炎或克罗恩病患者。已经有血栓形成或在入院时接受任何抗血栓治疗的患者被排除在外。调查住院期间静脉血栓栓塞的发展情况，并使用倾向评分匹配和治疗加权逆概率分析估计静脉血栓栓塞与CVC留置相关的风险。结果:共有497例IBD(溃疡性结肠炎，327例;克罗恩病，170例)被纳入研究。9.30%(12/129)插管患者发生静脉血栓栓塞，0.82%(3/368)未插管患者发生静脉血栓栓塞。倾向评分匹配产生127对匹配的患者。置管组发生静脉血栓栓塞的几率高于未置管组(优势比，13.15;95%置信区间，1.68-102.70)。在处理加权逆概率分析中也得到了类似的结果(优势比，11.02;95%置信区间为2.64-46.10)。结论:CVC放置是日本住院IBD患者无血栓预防的VTE的主要危险因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Intestinal Research GASTROENTEROLOGY & HEPATOLOGY-

CiteScore

7.40

自引率

10.20%

发文量

审稿时长

38 weeks

期刊介绍： Intestinal Research (Intest Res) is the joint official publication of the Asian Organization for Crohn''s and Colitis (AOCC), Chinese Society of IBD (CSIBD), Japanese Society for IBD (JSIBD), Korean Association for the Study of Intestinal Diseases (KASID), Taiwan Society of IBD (TSIBD) and Colitis Crohn''s Foundation (India) (CCF, india). The aim of the Journal is to provide broad and in-depth analysis of intestinal diseases, especially inflammatory bowel disease, which shows increasing tendency and significance. As a Journal specialized in clinical and translational research in gastroenterology, it encompasses multiple aspects of diseases originated from the small and large intestines. The Journal also seeks to propagate and exchange useful innovations, both in ideas and in practice, within the research community. As a mode of scholarly communication, it encourages scientific investigation through the rigorous peer-review system and constitutes a qualified and continual platform for sharing studies of researchers and practitioners. Specifically, the Journal presents up-to-date coverage of medical researches on the physiology, epidemiology, pathophysiology, clinical presentations, and therapeutic interventions of the intestinal diseases. General topics of interest include inflammatory bowel disease, colon and small intestine cancer or polyp, endoscopy, irritable bowel syndrome and other motility disorders, infectious enterocolitis, intestinal tuberculosis, and so forth. The Journal publishes diverse types of academic materials such as editorials, clinical and basic reviews, original articles, case reports, letters to the editor, brief communications, perspective, statement or commentary, and images that are useful to clinicians and researchers.