title: Clinical presentation of venous thromboembolism in inflammatory bowel disease.
abstract: OBJECTIVE
  Patients with inflammatory bowel disease (IBD) are at increased risk of venous thromboembolism (VTE), but data on frequency, site of thrombosis and risk factors are limited. We sought to determine prevalence, incidence as well as location and clinical features of first VTE among IBD patients.
  
  
  METHODS
  We evaluated a cohort of 2811 IBD patients for a history of symptomatic, objectively confirmed first VTE, recruited from 14 referral centers. Patients with VTE before IBD diagnosis or cancer were excluded. Incidence rates were calculated based on person-years from IBD diagnosis to first VTE or end of follow-up, respectively.
  
  
  RESULTS
  2784 patients (total observation time 24,778 person-years) were analyzed. Overall, of 157 IBD patients with a history of VTE, 142 (90.4%) had deep vein thrombosis (DVT) and/or pulmonary embolism (PE), whereas 15 (9.6%) had cerebral, portal, mesenteric, splenic or internal jugular vein thrombosis. The prevalence and incidence rate of all VTE was 5.6% and 6.3 per 1000 person years, respectively. Patients with VTE were older at IBD diagnosis than those without VTE (34.4±14.8years vs 32.1±14.4years, p=0.045), but did not differ regarding sex, underlying IBD and disease duration. 121 (77.1%) VTE were unprovoked, 122 (77.7%) occurred in outpatients and 78 (60.9%) in patients with active disease. Medication at first VTE included corticosteroids (42.3%), thiopurines (21.2%), and infliximab (0.7%).
  
  
  CONCLUSIONS
  VTE is frequent in IBD patients. Most of them are unprovoked and occur in outpatients. DVT and PE are most common and unusual sites of thrombosis are rare.
authors.affiliation: Department of Internal Medicine III, Medical University Vienna, Austria.
authors.forename: Pavol
authors.initials: P
authors.lastname: Papay
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Miehsler
authors.forename: Herbert
authors.initials: H
authors.lastname: Tilg
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Petritsch
authors.forename: Walter
authors.initials: W
authors.lastname: Reinisch
authors.forename: Andreas
authors.initials: A
authors.lastname: Mayer
authors.forename: Thomas
authors.initials: T
authors.lastname: Haas
authors.forename: Arthur
authors.initials: A
authors.lastname: Kaser
authors.forename: Thomas
authors.initials: T
authors.lastname: Feichtenschlager
authors.forename: Harry
authors.initials: H
authors.lastname: Fuchssteiner
authors.forename: Peter
authors.initials: P
authors.lastname: Knoflach
authors.forename: Harald
authors.initials: H
authors.lastname: Vogelsang
authors.forename: Reingard
authors.initials: R
authors.lastname: Platzer
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Tillinger
authors.forename: Bernhard
authors.initials: B
authors.lastname: Jaritz
authors.forename: Alfons
authors.initials: A
authors.lastname: Schmid
authors.forename: Benedikt
authors.initials: B
authors.lastname: Blaha
authors.forename: Clemens
authors.initials: C
authors.lastname: Dejaco
authors.forename: Anna
authors.initials: A
authors.lastname: Sobala
authors.forename: Ansgar
authors.initials: A
authors.lastname: Weltermann
authors.forename: Sabine
authors.initials: S
authors.lastname: Eichinger
authors.forename: Gottfried
authors.initials: G
authors.lastname: Novacek
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D001317:Austria / Q000453:epidemiology; D002550:Cerebral Veins; D005260:Female; D006801:Humans; D015994:Incidence; D015212:Inflammatory Bowel Diseases / Q000188:drug therapy / Q000453:epidemiology*; D007601:Jugular Veins; D007866:Leg / Q000098:blood supply; D008297:Male; D008642:Mesenteric Veins; D008875:Middle Aged; D011169:Portal Vein; D015995:Prevalence; D011655:Pulmonary Embolism / Q000453:epidemiology*; D012189:Retrospective Studies; D013162:Splenic Vein; D013997:Time Factors; D054556:Venous Thromboembolism / Q000453:epidemiology*; D020246:Venous Thrombosis / Q000453:epidemiology*; D055815:Young Adult
keywords: Crohn's disease; Deep venous thromosis; Pulmonary embolism; Ulcerative colitis; Venous thromboembolic events; Venous thromboembolism