Razik Roshan, Bernstein Charles N, Sam Justina, Thanabalan Reka, Nguyen Geoffrey C
Mount Sinai Hospital Centre for Inflammatory Bowel Disease, University of Toronto, Toronto, Ontario, Canada.
Can J Gastroenterol. 2012 Nov;26(11):795-8. doi: 10.1155/2012/175249.
Patients with inflammatory bowel disease (IBD) who are hospitalized with disease flares are known to be at an increased risk of venous thromboembolism (VTE). This is a preventable complication; however, there is currently no standardized approach to the prevention and management of VTE.
To characterize the opinions and general prophylaxis patterns of Canadian gastroenterologists and IBD experts.
A survey questionnaire was sent to Canadian gastroenterologists affiliated with a medical school or IBD referral centre. Participants were required to be practicing physicians who had completed all of their training and had been involved in the care of IBD patients within the previous 12 months. Various clinical scenarios were presented and demographic data were solicited.
The majority of respondents were practicing in an academic setting (95%) and considered themselves to be IBD experts or subspecialists (71%). Eighty-three per cent reported providing VTE prophylaxis most, if not all of the time, and most (96%) used pharmacological prophylaxis alone, usually heparin or one of its analogues. There was less consistency among respondents with respect to whether IBD patients in remission, but admitted for another condition, should be given prophylaxis. There was also less agreement regarding the duration of anticoagulation in patients with confirmed VTE.
There was a general consensus among academic gastroenterologists that IBD inpatients are at an increased risk for VTE and would benefit from VTE prophylaxis. However, areas of uncertainty still exist and the IBD community would benefit from evidence-based clinical practice guidelines to standardize the management of this important problem.
已知因疾病发作而住院的炎症性肠病（IBD）患者发生静脉血栓栓塞（VTE）的风险增加。这是一种可预防的并发症；然而，目前尚无预防和管理VTE的标准化方法。
描述加拿大胃肠病学家和IBD专家的意见及一般预防模式。
向隶属于医学院或IBD转诊中心的加拿大胃肠病学家发送调查问卷。参与者须为已完成所有培训且在过去12个月内参与过IBD患者护理的执业医师。呈现了各种临床情景并收集了人口统计学数据。
大多数受访者在学术机构执业（95%），并认为自己是IBD专家或亚专科医生（71%）。83%的受访者报告在大多数（即便不是全部）情况下会提供VTE预防措施，且大多数（96%）仅使用药物预防，通常是肝素或其类似物之一。对于缓解期但因其他疾病入院的IBD患者是否应给予预防措施，受访者之间的一致性较低。对于确诊VTE患者的抗凝持续时间，也存在较少的共识。
学术性胃肠病学家普遍达成共识，即IBD住院患者发生VTE的风险增加，且会从VTE预防中获益。然而，仍存在不确定性领域，IBD领域将受益于基于证据的临床实践指南，以规范这一重要问题的管理。
