title: Inflammatory bowel disease increases the risks of deep vein thrombosis and pulmonary embolism in the hospitalized patients: a nationwide cohort study.
abstract: OBJECTIVE
  We conducted a nationwide, population-based cohort study to evaluate the effects of inflammatory bowel disease (IBD) on the risks of developing deep vein thrombosis (DVT) and pulmonary embolism (PE) in Taiwan.
  
  
  METHODS
  We randomly selected the study cohort with IBD from the National Health Insurance (NHI) database (N = 23.74 million) and the control cohort without IBD who was frequency-matched the study cohort based on age, sex, and index year to each IBD patient between 2000 and 2010. Using a follow-up period ending in 2011, we analyzed the risks of DVT and PE using Cox proportional hazard regression analyses.
  
  
  RESULTS
  The 11 445 IBD patients and 45 780 controls were followed 65 256 and 293 377 person-years, respectively. After adjusting for age, sex, and comorbidities, the risks of IBD patients developing DVT and PE was 1.98-fold and 1.80-fold higher, respectively, than those of the comparison cohort. The IBD patients presenting with 2 or more annual hospitalizations exhibited a significantly greater risk of developing DVT (adjusted hazard ratio [HR] 32.9, 95% confidence interval [CI] 20.5-52.8) and PE (adjusted HR = 24.2, 95% CI = 11.1-52.9) than did the comparison cohort. Women with IBD showed a significantly greater risk of DVT and PE than did the comparison cohort (adjusted HR = 1.80, 95% CI = 1.18-2.78 for DVT and adjusted HR=2.08, 95% CI = 1.14-3.80 for PE respectively).
  
  
  CONCLUSIONS
  The risks of DVT and PE are significantly higher in IBD patients compared with risks in the general population.
  Thromboembolic complications are easily overlooked in IBD patients.
  The risks of DVT and PE are significantly higher in IBD patients.
authors.affiliation: Department of Internal Medicine, Taichung Hospital, Ministry of Health and Welfare, Taichung, Taiwan; Department of Health Services Administration, China Medical University, Taichung, Taiwan; Department of Healthcare Administration, Central Taiwan University of Science and Technology, Taichung, Taiwan.
authors.forename: Wei-Sheng
authors.initials: WS
authors.lastname: Chung
authors.affiliation: Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan; Department of Public Health, China Medical University, Taichung, Taiwan.
authors.forename: Cheng-Li
authors.initials: CL
authors.lastname: Lin
authors.affiliation: Department of Respiratory and Critical Care, China Medical University Hospital, Taichung, Taiwan; Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan.
authors.forename: Wu-Huei
authors.initials: WH
authors.lastname: Hsu
authors.affiliation: Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan; Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan. Electronic address: d10040@mail.cmuh.org.tw.
authors.forename: Chia-Hung
authors.initials: CH
authors.lastname: Kao
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D006760:Hospitalization; D006801:Humans; D015994:Incidence; D015212:Inflammatory Bowel Diseases / Q000150:complications*; D008297:Male; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000209:etiology*; D012306:Risk; D012307:Risk Factors; D020246:Venous Thrombosis / Q000209:etiology*; D055815:Young Adult
keywords: Deep vein thrombosis (DVT); Inflammatory bowel disease (IBD); National Health Insurance (NHI); Pulmonary embolism (PE)