Non-surgical porto-mesenteric vein thrombosis is associated with worse long-term outcomes in inflammatory bowel diseases.
OBJECTIVE
Our aim was to assess the risk factors for non-surgery-related portal and mesenteric vein thrombosis (PMVT) and its impact on the outcomes of inflammatory bowel diseases (IBD).


METHODS
All patients with a concurrent diagnosis of IBD and PMVT between January 2004 and October 2013 were identified from the electronic medical record (study group; n = 20). Patients were matched for age, sex, and IBD phenotype with control IBD patients who had no PMVT, with a ratio of 1:3 (control group; n = 60). Risk factors for PMVT and IBD-related outcomes at one year after diagnosis of PMVT were compared between the two groups.


RESULTS
Of the 20 patients in the Study group, 6 (30%) had UC, 14 (70%) had CD and 11 (55%) were male. On multivariable analysis, inpatient status (odds ratio [OR] 6.88; 95% confidence interval [CI] 1.88-25.12) and baseline corticosteroid use (OR 4.39; 95% CI 1.27-15.19) were found to be independent risk factors for the development of PMVT. At one-year follow-up, PMVT patients were more likely to have an adverse outcome of IBD, including subsequent emergency room visit (26.3% vs. 1.7%; P = 0.003), hospitalization for medical management (60.0% vs. 20.0%; P = 0.001) or IBD-related surgery (65.0% vs. 26.7%; P = 0.003) than the non-PMVT controls. In multivariable analysis, PMVT (OR 5.19; 95% CI 1.07-25.28) and inpatient status (OR 8.92; 95% CI 1.33-59.84) were found to be independent risk factors for poor outcome, whereas baseline immunomodulator use (OR 0.07; 95% CI 0.01-0.51) was found to be a protective factor.


CONCLUSIONS
IBD patients who were inpatients or receiving corticosteroid therapy had an increased risk of the development of PMVT. The presence of PMVT was associated with poor clinical outcomes in IBD.
Department of Internal Medicine, The Cleveland Clinic Foundation, Cleveland, OH, USA.
Zubin
Z
Arora
Department of Gastroenterology and Hepatology, The Cleveland Clinic Foundation, Cleveland OH, USA.
Xianrui
X
Wu
Department of Gastroenterology and Hepatology, The Cleveland Clinic Foundation, Cleveland OH, USA.
Udayakumar
U
Navaneethan
Department of Gastroenterology and Hepatology, The Cleveland Clinic Foundation, Cleveland OH, USA shenb@ccf.org.
Bo
B
Shen
inflammatory bowel diseases; outcomes; portal vein thrombosis; risk factors