The increasing incidence of thromboembolic events among hospitalized patients with inflammatory bowel disease

Background: We performed a national population-based study examining the incidence of both venous and arterial thromboembolic events in patients hospitalized with inflammatory bowel disease over the past decade.

Methods: A retrospective cross-sectional analysis using the Nationwide Inpatient Sample Database was performed. Patients hospitalized with Crohn's disease and ulcerative colitis were identified using ICD-9 codes. The incidence of clinically relevant venous thromboembolic events and arterial thromboembolic events including myocardial infarction, visceral ischemia, cerebrovascular accidents, and peripheral arterial events was examined.

Results: During the study period, 461,415 hospitalized inflammatory bowel disease patients were identified. Among these patients, 28,820 had a diagnosis of a thromboembolic event (overall prevalence of 6%). The incidence of thromboembolic events in patients with inflammatory bowel disease rose from 5.65% in 2000 to 7.17% by 2009. There were 18,270 (3.96%) patients who had an arterial thrombotic event, the most common being myocardial infarction (50%), followed by visceral ischemia (25%), and cerebrovascular incidents (22%). There were 11,083 (2.4%) patients identified to have had a venous thrombotic event, with the most common manifestation being deep vein thrombosis (77%), pulmonary embolism (32%), and portal vein thrombosis (3.9%).

Conclusion: An increasing incidence of thromboembolic event in patients with inflammatory bowel disease was observed over the past decade. Interestingly, there were more arterial thrombotic events in comparison to venous thrombotic events.