The Incidence and Predictive Factors of Thromboembolism During Hospitalizations for Inflammatory Bowel Disease Flare-Ups: A Retrospective Cohort Study in Taiwan

Background/aims: Thromboembolism (TE) notably increase morbidity and mortality among inflammatory bowel disease (IBD) patients. Despite ECCO's 2024 guidelines advocating routine anticoagulant prophylaxis, its application in Asia remains inconsistent due to a lack of regional studies. This research investigates the incidence and predictors of TE during IBD-related hospitalizations in Taiwan, aiming to improve prevention strategies.

Materials and methods: Our retrospective cohort study included 282 adult IBD patients, accounting for 515 flare-up related hospitalizations at Linkou Chang Gung Memorial Hospital from January 2001 to March 2024. Patients were classified into two groups based on the occurrence of TE.

Results: The incidence of TE was 1.55%. The TE group had significantly lower body weight, body mass index (BMI), hemoglobin and albumin levels but higher rate of sepsis and concurrent autoimmune diseases compared to the non-TE group. Multivariate analysis indicated that concurrent autoimmune diseases and hypoalbuminemia were independent predictors of TE. The optimal serum albumin cutoff was established at 3.01 g/dL, with sensitivities and specificities of 87.5% and 77.3%, respectively.

Conclusions: This pioneering Asian study identifies concurrent autoimmune diseases and low serum albumin as key predictors of TE in hospitalized IBD patients. We recommend targeted anticoagulant prophylaxis for IBD patients with these risk factors, especially when serum albumin falls below 3.01 g/dL.