Amakye Dominic, Kesiena Onoriode, Ademiluyi Ademayowa, Gavor Margaret, Rabeeah Zahraa
Graduate Medical Education, Piedmont Athens Regional Medical Center, Athens, USA.
Internal Medicine, Piedmont Athens Regional Medical Center, Athens, USA.
Cureus. 2022 Sep 15;14(9):e29178. doi: 10.7759/cureus.29178. eCollection 2022 Sep.
Objective We set out to determine the rate of pharmacological venous thromboembolism (VTE) prophylaxis among patients admitted with inflammatory bowel disease (IBD) and indirectly compare it to national trends. We also assessed the demographic and clinical correlates for non-prescription of pharmacologic VTE prophylaxis among IBD patients with and without a flare. Methods We extracted data from 123 patients admitted to our facility with IBD from September 2018 to August 2020 retrospectively. Out of this cohort, 26 patients were excluded and 96 were included in our analysis. Baseline characteristics were analyzed using descriptive statistics. Multiple logistic regression was used to evaluate the correlates of pharmacological VTE prophylaxis use in individuals with IBD and to analyze the predictors of VTE prophylaxis use in patients with IBD flares. Results Out of the 96 patients with IBD included in this study, 61 (63.5%) presented with an IBD flare, and among those with a flare, 26/61 (42.6%) received VTE prophylaxis. IBD patients aged ≥ 65 years and of Black race were less likely to be placed on pharmacological VTE prophylaxis (adjusted odds ratio (AOR) 0.20, 95% CI (0.06 - 0.70), p-value 0.012) and (AOR 0.16, 95% CI (0.05 - 0.50), p-value 0.002) respectively. Among those with a flare, the presence of bright red bleeding per rectum was associated with a low rate of pharmacologic VTE use (AOR 0.01, 95% CI (0.00 -1.78), p-value 0.001). Overall the rate of VTE prophylaxis use in the IBD patient cohort was 56.3% and this was irrespective of flare status. Conclusion Our study showed the low rate of pharmacologic VTE prophylaxis use in IBD patients at this center and this finding was in line with national trends. Interestingly age and the race of patients played a major role in the decision to provide pharmacological VTE prophylaxis but the reason for this finding was not explored by our study. A larger multi-center study is needed to further evaluate these relationships.
目的 我们旨在确定炎症性肠病（IBD）患者中药物性静脉血栓栓塞（VTE）预防的比例，并间接将其与全国趋势进行比较。我们还评估了有或无疾病发作的IBD患者未进行药物性VTE预防的人口统计学和临床相关性。方法 我们回顾性提取了2018年9月至2020年8月在我们机构收治的123例IBD患者的数据。在这个队列中，排除了26例患者，96例纳入我们的分析。使用描述性统计分析基线特征。采用多因素logistic回归评估IBD患者使用药物性VTE预防的相关性，并分析IBD发作患者使用VTE预防的预测因素。结果 在本研究纳入的96例IBD患者中，61例（63.5%）出现IBD发作，在发作患者中，26/61例（42.6%）接受了VTE预防。年龄≥65岁的IBD患者和黑人患者接受药物性VTE预防的可能性较小（校正比值比（AOR）分别为0.20，95%置信区间（CI）（0.06 - 0.70），p值0.012）和（AOR 0.16，95%CI（0.05 - 0.50），p值0.002）。在发作患者中，直肠鲜红色出血与药物性VTE使用率低相关（AOR 0.01，95%CI（0.00 - 1.78），p值0.001）。总体而言，IBD患者队列中VTE预防的使用率为56.3%，且与发作状态无关。结论 我们的研究表明该中心IBD患者药物性VTE预防的使用率较低，这一发现与全国趋势一致。有趣的是，患者的年龄和种族在决定是否提供药物性VTE预防方面起主要作用，但本研究未探讨这一发现的原因。需要开展更大规模的多中心研究来进一步评估这些关系。
