title: Venous thrombotic events in hospitalized children and adolescents with inflammatory bowel disease.
abstract: BACKGROUND
  Adults with inflammatory bowel disease (IBD) have an increased risk of venous thrombotic events (TEs). We sought to evaluate the risk for TE in children and adolescents with IBD using a large population database.
  
  
  METHODS
  The triennial Healthcare Cost and Utilization Project Kids' Inpatient Database was used in a retrospective cohort study of hospitalized children in the United States across 1997, 2000, 2003, 2006, and 2009. Billing codes were used to identify discharges with Crohn disease, ulcerative colitis, pulmonary embolism, deep vein thrombosis, thrombophlebitis, thrombosis of intracranial venous sinus, Budd-Chiari syndrome, and portal vein thrombosis. A logistic regression model was fitted to quantify the increased risk of TE in children with IBD, while adjusting for other risk factors of thrombosis.
  
  
  RESULTS
  The total weighted number of pediatric discharges was 7,448,292, and 68,394 (0.92%) were identified with IBD. The incidence of any TE in a hospitalized child or adolescent with IBD was 117.9/10,000 with a relative risk (95% confidence interval) of 2.36 (2.15-2.58). The adjusted odds ratio for any TE in a patient with IBD without surgery was 1.22 (1.08-1.36). Risk factors for TE among patients with IBD include older age, central venous catheter, parenteral nutrition, and an identified hypercoagulable condition. There is an increasing trend of TE in both the IBD and non-IBD patients.
  
  
  CONCLUSIONS
  Hospitalized children and adolescents with IBD are at increased risk for TE. Conservative methods of TE prevention including hydration, mobilization, or pneumatic devices should be considered in hospitalized patients with IBD.
authors.affiliation: Department of Pediatrics, Uniformed Services University of Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814, USA. cade.nylund@usuhs.mil
authors.forename: Cade M
authors.initials: CM
authors.lastname: Nylund
authors.forename: Anthony
authors.initials: A
authors.lastname: Goudie
authors.forename: Jose M
authors.initials: JM
authors.lastname: Garza
authors.forename: Gary
authors.initials: G
authors.lastname: Crouch
authors.forename: Lee A
authors.initials: LA
authors.lastname: Denson
mesh_terms: D000293:Adolescent; D000367:Age Factors; D001778:Blood Coagulation Disorders / Q000150:complications; D006502:Budd-Chiari Syndrome / Q000453:epidemiology / Q000209:etiology*; D062905:Central Venous Catheters / Q000009:adverse effects; D005260:Female; D006760:Hospitalization; D006801:Humans; D015994:Incidence; D015212:Inflammatory Bowel Diseases / Q000150:complications*; D016015:Logistic Models; D008297:Male; D010288:Parenteral Nutrition / Q000009:adverse effects; D011655:Pulmonary Embolism / Q000453:epidemiology / Q000209:etiology*; D012189:Retrospective Studies; D012307:Risk Factors; D012851:Sinus Thrombosis, Intracranial / Q000453:epidemiology / Q000209:etiology*; D013924:Thrombophlebitis / Q000453:epidemiology / Q000209:etiology*; D013927:Thrombosis / Q000453:epidemiology / Q000209:etiology*; D014481:United States / Q000453:epidemiology