Bernstein C N, Blanchard J F, Houston D S, Wajda A
Department of Internal Medicine, University of Manitoba, Winnipeg, Canada.
Thromb Haemost. 2001 Mar;85(3):430-4.
There is an impression mostly from specialty clinics that patients with inflammatory bowel disease (IBD) have an increased risk of venous thromboembolic disorders. Our aim was to determine the incidence of deep venous thrombosis (DVT) and pulmonary embolism (PE) from a population-based database of IBD patients and, to compare the incidence rates to that of an age, gender and geographically matched population control group.
IBD patients identified from the administrative claims data of the universal provincial insurance plan of Manitoba were matched 1:10 to randomly selected members of the general population without IBD by year, age, gender, and postal area of residence using Manitoba Health's population registry. The incidence of hospitalization for DVT and PE was calculated from hospital discharge abstracts using ICD-9-CM codes 451.1, 453.x for DVT and 415.1x for PE. Rates were calculated based on person-years of follow-up for 1984-1997. Comparisons to the population cohort yielded age-adjusted incidence rate ratios (IRR). Rates were calculated based on person-years of follow-up (Crohn's disease = 21,340, ulcerative colitis = 19,665) for 1984-1997.
In Crohn's disease the incidence rate of DVT was 31.4/10,000 person-years and of PE was 10.3/10,000 person-years. In ulcerative colitis the incidence rates were 30.0/10,000 person-years for DVT and 19.8/10,000 person-years for PE. The IRR was 4.7 (95% CI, 3.5-6.3) for DVT and 2.9 (1.8-4.7) for PE in Crohn's disease and 2.8 (2.1-3.7) for DVT and 3.6 (2.5-5.2) for PE, in ulcerative colitis. There were no gender differences for IRR. The highest rates of DVT and PE were seen among patients over 60 years old; however the highest IRR for these events were among patients less than 40 years.
IBD patients have a threefold increased risk of developing DVT or PE.
大多来自专科诊所的印象是，炎症性肠病（IBD）患者发生静脉血栓栓塞性疾病的风险增加。我们的目的是从一个基于人群的IBD患者数据库中确定深静脉血栓形成（DVT）和肺栓塞（PE）的发病率，并将发病率与年龄、性别和地理位置匹配的人群对照组进行比较。
从曼尼托巴省全民省级保险计划的行政索赔数据中识别出的IBD患者，通过曼尼托巴省卫生部门的人口登记系统，按年份、年龄、性别和居住邮政区域与随机选择的无IBD的普通人群成员以1:10的比例进行匹配。使用ICD-9-CM编码451.1、453.x表示DVT，415.1x表示PE，从医院出院摘要中计算DVT和PE的住院发病率。发病率基于1984 - 1997年的随访人年数计算。与人群队列的比较得出年龄调整发病率比（IRR）。发病率基于1984 - 1997年的随访人年数计算（克罗恩病 = 21,340，溃疡性结肠炎 = 19,665）。
在克罗恩病中，DVT的发病率为31.4/10000人年，PE的发病率为10.3/10000人年。在溃疡性结肠炎中，DVT的发病率为30.0/10000人年，PE的发病率为19.8/10000人年。克罗恩病中DVT的IRR为4.7（95%CI，3.5 - 6.3），PE为2.9（1.8 - 4.7）；溃疡性结肠炎中DVT的IRR为2.8（2.1 - 3.7），PE为3.6（2.5 - 5.2）。IRR没有性别差异。DVT和PE的最高发病率出现在60岁以上的患者中；然而，这些事件的最高IRR出现在40岁以下的患者中。
IBD患者发生DVT或PE的风险增加了两倍。
