title: Thromboembolism as an important complication of inflammatory bowel disease.
abstract: BACKGROUND
  Patients with inflammatory bowel disease (IBD) have a higher risk of developing thromboembolic events (TE) compared with the healthy population.
  
  
  OBJECTIVE
  This study aimed to describe a cohort of IBD patients with a history of TE focusing on recurrence of TE, disease activity and IBD medication at the time of TE and surgery before TE.
  
  
  METHODS
  In a retrospective monocentric cohort study, we included IBD patients in whom an arterial and/or venous TE occurred.
  
  
  RESULTS
  Eighty-four IBD patients with a history of TE (63% Crohn's disease, 44% men) and a mean age of 45±15 years were included; 25/84 patients (30%) were identified to have recurrent TE. Seventy out of 84 (83%) developed a venous TE, with a deep vein thrombosis as the major manifestation (28/70, 40%), followed by a pulmonary embolism (16/70, 23%). At the time of TE, 60/84 (71%) patients were diagnosed with active disease. In all, 23% patients were on 5-aminosalicylic acids, 36% on steroids, 18% on azathioprine, 5% on methotrexate, 12% on biologicals and 23% were not receiving specific IBD treatment. Moreover, within a 6-month period preceding the TE, 28/84 (33%) patients underwent surgery, of whom 17% received thromboprophylaxis at hospital discharge.
  
  
  CONCLUSIONS
  We confirm the association between disease activity and the occurrence of TE. A substantial number of patients had additional risk factors such as recurrence of TE. In all, 36% received steroids at the time of TE and 33% underwent recent surgery, of whom only a minority received thromboprophylaxis at hospital discharge. Further efforts are required to increase thromboprophylaxis in at-risk patients.
authors.affiliation: aLaboratory for Therapeutic and Diagnostic Antibodies, Department of Pharmaceutical and Pharmacological Sciences, Katholieke Universiteit Leuven bTranslational Research in Gastrointestinal Disorders, Department of Gastroenterology, UZ Leuven, Leuven, Belgium.
authors.forename: Lize
authors.initials: L
authors.lastname: Bollen
authors.forename: Niels
authors.initials: N
authors.lastname: Vande Casteele
authors.forename: Vera
authors.initials: V
authors.lastname: Ballet
authors.forename: Gert
authors.initials: G
authors.lastname: van Assche
authors.forename: Marc
authors.initials: M
authors.lastname: Ferrante
authors.forename: Séverine
authors.initials: S
authors.lastname: Vermeire
authors.forename: Ann
authors.initials: A
authors.lastname: Gils
mesh_terms: D000068879:Adalimumab / Q000627:therapeutic use; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D001379:Azathioprine / Q000627:therapeutic use; D003093:Colitis, Ulcerative / Q000150:complications* / Q000188:drug therapy / Q000601:surgery; D003424:Crohn Disease / Q000150:complications* / Q000188:drug therapy / Q000601:surgery; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D000069285:Infliximab / Q000627:therapeutic use; D008297:Male; D019804:Mesalamine / Q000627:therapeutic use; D008727:Methotrexate / Q000627:therapeutic use; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000209:etiology*; D012008:Recurrence; D012189:Retrospective Studies; D012720:Severity of Illness Index; D054556:Venous Thromboembolism / Q000209:etiology*; D020246:Venous Thrombosis / Q000209:etiology*
chemical_list: D000305:Adrenal Cortex Hormones; D000894:Anti-Inflammatory Agents, Non-Steroidal; D007166:Immunosuppressive Agents; D019804:Mesalamine; D000069285:Infliximab; D000068879:Adalimumab; D001379:Azathioprine; D008727:Methotrexate