Poster Session II - A275 PREDICTING RISK FOR VENOUS THROMBOEMBOLISM AFTER HOSPITAL DISCHARGE IN PATIENTS WITH INFLAMMATORY BOWEL DISEASE

TL;DR

This study identifies risk factors for blood clots after hospital discharge in inflammatory bowel disease patients, aiming to help identify those needing extended prevention.

Contribution

The study is the first to identify specific clinical predictors of post-discharge venous thromboembolism risk in inflammatory bowel disease patients.

Findings

Five independent risk factors for VTE after discharge were identified: prior VTE, central venous catheter, cancer, low hemoglobin, and age over 45.

Only 8.1% of discharges received extended thromboprophylaxis, suggesting a need for better risk stratification.

The findings aim to inform a future multicenter prediction tool for post-discharge VTE risk in IBD patients.

Abstract

Patients with inflammatory bowel disease (IBD) face an elevated risk of venous thromboembolism (VTE) during hospitalization. Emerging evidence suggests this risk may persist post-discharge, yet no validated tools exist to identify high-risk patients who may benefit from extended thromboprophylaxis.

To identify risk factors associated with risk of VTE among patients with IBD patients within 3 months following hospital discharge.

We performed at retrospective, matched case-control study at The Ottawa Hospital (2009-2024). Adults (>17 years) with pre-existing IBD who developed a VTE were identified by our institutional databases using validated ICD-10 codes, confirmed by chart review. Patients hospitalized ≥48 hours who developed a VTE within 3 months after hospital discharge (cases) were matched to 3 patients without post-dicharge VTE (controls) by discharge date. Candidate predictors were selected a priori based on literature review. Univariable analysis identified variables with p < 0.05. Next, multivariable conditional logistic regression with stratification by matched set was performed.

We identified 468 eligible hospital discharges, 117 eligible post-discharges were identified occurring within 3 months prior to a VTE event, matched to 351 controls (Table 1). Extended thromboprophylaxis was only given to 8.1% of discharges. Multivariable analysis identified five independent predictors (Figure 1): prior VTE (OR 5.60; 95% CI 2.95-10.62), central venous catheter during admission (OR 5.09; 2.14-12.07), cancer (past/current) (OR 3.41; 1.45-8.02), hemoglobin <100 g/L (OR 2.43; 1.32-4.46), and age >45 years (OR 2.32; 1.23-4.39) (all p < 0.01).

Descriptive statistics and univariable analysis of IBD patients with and without post-discharge VTE.

In this single-center retrospective study, we identified multiple clinical variables that are associated with VTE after hospital discharge in patients with IBD. This work will help to create a future multicenter clinical prediction tool to identify which patients with IBD have the highest risk of developing VTE after hospital discharge.

Ottawa Hospital Research Institute

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