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Increased Rate of Venous Thromboembolism in Hospitalized Inflammatory Bowel Disease Patients with Clostridium Difficile Infection. Inflamm Bowel Dis 2017 10;23(10):1847-1852

Date

08/25/2017

Pubmed ID

28837518

DOI

10.1097/MIB.0000000000001218

Scopus ID

2-s2.0-85029761631   7 Citations

Abstract

BACKGROUND: Risk of venous thromboembolism (VTE) in patients with inflammatory bowel disease (IBD) is well established; however, there is paucity of data on the potential added risk of VTE in patients with IBD with Clostridium difficile infection (CDI). We sought to study the difference in VTE rates in hospitalized patients with IBD with CDI compared to those without CDI.

METHODS: We queried Nationwide Inpatient Sample from year 2011 to identify patients ≥18 years of age with a discharge diagnosis of IBD (i.e., Crohn's disease and ulcerative colitis) based on ICD-9-CM codes 555.xx and 556.xx, respectively. Patients were further divided into 2 groups: those with and without CDI. To adjust and control for potential baseline differences between groups, 1:1 propensity matching was performed. Multivariate regression analysis was used to evaluate the difference in VTE rates in 2 groups.

RESULTS: Of 312,147 patients with the discharge diagnosis of IBD, 12,560 (4%) had CDI. VTE was present 6% in group with CDI versus 3% in group without CDI (P < 0.001). On performing multivariate analysis after propensity-score matching, CDI was significantly associated with VTE (adjusted odds ratio 1.7, 95% confidence interval 1.4-2.2, P < 0.001). On subgroup analysis, Crohn's disease with CDI had a higher association with VTE compared with Crohn's disease only. Similarly, ulcerative colitis with CDI had a higher association with VTE compared with ulcerative colitis only.

CONCLUSIONS: Rate of VTE was higher in hospitalized patients with IBD with CDI compared with those without CDI, necessitating extra vigilance in this patient population.

Author List

Bhandari S, Mohammed Abdul MK, Dhakal B, Kreuziger LB, Saeian K, Stein D

Authors

Binod Dhakal MD Assistant Professor in the Medicine department at Medical College of Wisconsin
Kia Saeian MD Professor in the Medicine department at Medical College of Wisconsin
Daniel J. Stein MD Associate Professor in the Medicine department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Adolescent
Adult
Clostridium Infections
Colitis, Ulcerative
Crohn Disease
Female
Humans
Inpatients
Male
Middle Aged
Multivariate Analysis
Odds Ratio
Propensity Score
Regression Analysis
Risk Factors
United States
Venous Thromboembolism
Young Adult
jenkins-FCD Prod-411 e00897e83867fcfa48419861683711f8d99adb75