Muhammad Ibrahim Khan, Muhammad Ikram Shah, Ghazala Shaheen, Muhammad Bilal, Shazia Siddiq, Muhammad Imran

Risk of Thrombosis and Mortality in Inflammatory Bowel Disease

Muhammad Ibrahim Khan, Muhammad Ikram Shah, Ghazala Shaheen, Muhammad Bilal, Shazia Siddiq, Muhammad Imran



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ABSTRACT

Background and Aim: Inflammatory bowel disease patients are more susceptible to risk of developing thrombosis, which leads to increased morbidity and mortality. The majority of hospitalized patients had venous thrombosis with active disease, but numerous cases occur in outpatient setting. The aim of the present study was to evaluate the risk of thrombosis and mortality in inflammatory bowel disease.

Methodology: This cross sectional study was conducted on 218 inflammatory bowel disease patients at the department of Medicine, Pak International Medical College Peshawar and Poonch Medical College / CMH  Rawlakot Azad Kashmir for duration of six months from March 2021 to August 2021. Demographic details and thrombosis profile along with ultrasonic and magnetic resonance imaging were investigated. All the patients were enrolled based on confirmed diagnosis of inflammatory bowel disease through histological findings, radiological and endoscopic evidences. Demographic details such as age, gender, and clinical details such as risk factors of thrombosis, smoking history, duration of disease, surgeries and pharmaceutical treatment, family history, and use of contraceptive were all recorded. Inflammatory bowel disease activity was defined based on CRP values and medical impression. Optimized treatment such as infliximab was considered in cases where doses increased to 10 mg/kg or interval reduced to 4-6 weeks whereas adalimumab was considered for interval of 1 week. For data analysis, SPSS version 21 was used.

Results: Out of 218 patients, 130 (59.8%) were Crohn’s disease (CD) diagnosed patients and 88 (39.2%) were diagnosed with ulcerative colitis (UC). Females 118 (54%) were prevalent than males 100 (46%) and the average age was 33.6±12.5 years with a mean disease duration of 9.72± 4.75 years. The 130 CD patients disease location was as follows: ileal in 23 (17.7%), colonic in 11 (8.5%), and ileocolonic in 27. (20.8%). The prevalence of upper GI involvement and upper GI restriction was 13 (10%) and 11 (8.5%) respectively. Based on behavior of disease (n=119), the prevalence of non-stricturing, non-penetrating, penetrating, and structuring were 31 (26.1%), 54 (41.4%), and 34 (28.6%) respectively. Out of 88 UC patients, the prevalence of pancolitis, left-sided disease, and proctitis were 55 (62.9%), 19 (21.6%) and 14 (15.9%) respectively. 

Conclusion: Our study found that preliminary evidence for the higher venous thromboembolism risks in patients with IBD associated with ulcerative colitis, steroid use, and ageing. The findings may help to raise clinician awareness and prevent IBD patients from venous thromboembolic complications.

Keywords: IBD, Venous thromboembolism, Risk factors



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