Division of Gastroenterology, NYU Grossman School of Medicine, New York, New York, USA.
Department of Medicine, Duke University Medical Center, Durham, North Carolina, USA.
Aliment Pharmacol Ther. 2022 Oct;56(7):1157-1167. doi: 10.1111/apt.17162. Epub 2022 Jul 25.
Venous thromboembolism (VTE) is a significant cause of morbidity and mortality among patients with inflammatory bowel disease (IBD). However, data on national trends remain limited.
To assess national trends in VTE-associated hospitalisations among patients with IBD as well as risk factors for, and mortality associated with, these events METHODS: Using the U.S. Nationwide Inpatient Sample from 2000-2018, temporal trends in VTE were assessed using the National Cancer Institute's Joinpoint Regression Program with estimates presented as the average annual percent change (AAPC) with 95% confidence intervals (CIs).
Between 2000 and 2018, there were 4,859,728 hospitalisations among patients with IBD, with 128,236 (2.6%) having a VTE, and 6352 associated deaths. The rate of VTE among hospitalised patients with IBD increased from 192 to 295 cases per 10,000 hospitalisations (AAPC 2.4%, 95%CI 1.4%, 3.4%, p < 0.001), and remained significant when stratified by ulcerative colitis (UC) and Crohn's disease as well as by deep vein thrombosis and pulmonary embolism. On multivariable analysis, increasing age, male sex, UC (aOR: 1.30, 95%CI 1.26, 1.33), identifying as non-Hispanic Black, and chronic corticosteroid use (aOR: 1.22, 95%CI 1.16, 1.29) were associated with an increased risk of a VTE-associated hospitalisation.
Rates of VTE-associated hospitalisations are increasing among patients with IBD. Continued efforts need to be placed on education and risk reduction.
静脉血栓栓塞症（VTE）是炎症性肠病（IBD）患者发病率和死亡率的重要原因。然而，关于全国趋势的数据仍然有限。
评估 IBD 患者中与 VTE 相关的住院治疗的全国趋势，以及这些事件的危险因素和死亡率。
使用 2000 年至 2018 年美国全国住院患者样本，使用国家癌症研究所的 Joinpoint 回归程序评估 VTE 的时间趋势，估计值表示平均年度百分比变化（AAPC）和 95%置信区间（CI）。
在 2000 年至 2018 年间，有 4859728 名 IBD 患者住院治疗，其中 128236 例（2.6%）患有 VTE，6352 例与死亡相关。IBD 住院患者中 VTE 的发生率从 192 例增加到 295 例每 10000 例住院治疗（AAPC 2.4%，95%CI 1.4%，3.4%，p<0.001），当按溃疡性结肠炎（UC）和克罗恩病以及深静脉血栓形成和肺栓塞分层时仍然显著。多变量分析显示，年龄增长、男性、UC（OR：1.30，95%CI 1.26，1.33）、非西班牙裔黑人、长期使用皮质类固醇（OR：1.22，95%CI 1.16，1.29）与 VTE 相关的住院风险增加相关。
IBD 患者中与 VTE 相关的住院治疗率正在上升。需要继续努力进行教育和降低风险。
