Zöller Bengt, Ohlsson Henrik, Waehrens Rasmus, Sundquist Jan, Sundquist Kristina
a Center for Primary Health Care Research, Lund University, Region Skåne , Malmö , Sweden.
Scand J Gastroenterol. 2018 Jun-Jul;53(7):784-789. doi: 10.1080/00365521.2018.1465118. Epub 2018 Apr 24.
Inflammatory bowel disease (IBD) is associated with venous thromboembolism (VTE). Whether functional gastrointestinal disorders, such as irritable bowel syndrome (IBS), are associated with VTE has not been determined. This nationwide study aimed to determine the risk of VTE in IBS outpatients in primary and specialist care.
We performed two matched case-control studies. Cases (n = 90,502) were individuals in Sweden aged 18-80 years with a first hospital diagnosis of VTE between 2001 and 2010. Five controls (n = 452,510) from the Swedish Total Population Register were matched to each case for birth, sex, country of birth, and education level. Diagnosis of IBS was determined in the Swedish hospital outpatient register. This procedure was replicated for the primary care population. As the Primary Care data did not have nationwide coverage, we only included individuals that were registered in the Primary Care database. A total of 9766 cases of hospital diagnosed VTE individuals could be found in the Primary Care population and they were matched to 48,830 controls also from the Primary health care population. Conditional logistic regression was used to determine odds ratio (OR) for first VTE diagnosis. Results The adjusted OR for VTE when IBS was diagnosed in hospital outpatient care was 1.49 (95% confidence interval 1.33-1.67). The crude OR for VTE was 1.18 (0.94-1.48) when IBS was diagnosed in primary care.
This is the first study describing an association between VTE and IBS. The results suggest that specialist treated IBS patients have increased risk of VTE.
炎症性肠病(IBD)与静脉血栓栓塞症(VTE)相关。诸如肠易激综合征(IBS)等功能性胃肠疾病是否与VTE相关尚未确定。这项全国性研究旨在确定基层医疗和专科医疗中IBS门诊患者发生VTE的风险。
我们进行了两项匹配病例对照研究。病例(n = 90502)为2001年至2010年间在瑞典首次被医院诊断为VTE的18至80岁个体。从瑞典总人口登记册中选取五名对照(n = 452510)与每个病例在出生、性别、出生国家和教育水平方面进行匹配。IBS的诊断在瑞典医院门诊登记册中确定。对基层医疗人群重复此程序。由于基层医疗数据没有全国范围的覆盖,我们仅纳入在基层医疗数据库中登记的个体。在基层医疗人群中总共发现9766例医院诊断为VTE的个体,并将他们与同样来自基层医疗人群的48830名对照进行匹配。使用条件逻辑回归来确定首次VTE诊断的比值比(OR)。结果在医院门诊护理中诊断为IBS时VTE的调整后OR为1.49(95%置信区间1.33 - 1.67)。在基层医疗中诊断为IBS时VTE的粗OR为1.18(0.94 - 1.48)。
这是第一项描述VTE与IBS之间关联的研究。结果表明专科治疗的IBS患者发生VTE的风险增加。