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Venous thrombotic events in hospitalized children and adolescents with inflammatory bowel disease.
J Pediatr Gastroenterol Nutr. 2013 May; 56(5):485-91.JP

Abstract

BACKGROUND

Adults with inflammatory bowel disease (IBD) have an increased risk of venous thrombotic events (TEs). We sought to evaluate the risk for TE in children and adolescents with IBD using a large population database.

METHODS

The triennial Healthcare Cost and Utilization Project Kids' Inpatient Database was used in a retrospective cohort study of hospitalized children in the United States across 1997, 2000, 2003, 2006, and 2009. Billing codes were used to identify discharges with Crohn disease, ulcerative colitis, pulmonary embolism, deep vein thrombosis, thrombophlebitis, thrombosis of intracranial venous sinus, Budd-Chiari syndrome, and portal vein thrombosis. A logistic regression model was fitted to quantify the increased risk of TE in children with IBD, while adjusting for other risk factors of thrombosis.

RESULTS

The total weighted number of pediatric discharges was 7,448,292, and 68,394 (0.92%) were identified with IBD. The incidence of any TE in a hospitalized child or adolescent with IBD was 117.9/10,000 with a relative risk (95% confidence interval) of 2.36 (2.15-2.58). The adjusted odds ratio for any TE in a patient with IBD without surgery was 1.22 (1.08-1.36). Risk factors for TE among patients with IBD include older age, central venous catheter, parenteral nutrition, and an identified hypercoagulable condition. There is an increasing trend of TE in both the IBD and non-IBD patients.

CONCLUSIONS

Hospitalized children and adolescents with IBD are at increased risk for TE. Conservative methods of TE prevention including hydration, mobilization, or pneumatic devices should be considered in hospitalized patients with IBD.

Authors+Show Affiliations

Department of Pediatrics, Uniformed Services University of Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814, USA. cade.nylund@usuhs.milNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

23232326

Citation

Nylund, Cade M., et al. "Venous Thrombotic Events in Hospitalized Children and Adolescents With Inflammatory Bowel Disease." Journal of Pediatric Gastroenterology and Nutrition, vol. 56, no. 5, 2013, pp. 485-91.
Nylund CM, Goudie A, Garza JM, et al. Venous thrombotic events in hospitalized children and adolescents with inflammatory bowel disease. J Pediatr Gastroenterol Nutr. 2013;56(5):485-91.
Nylund, C. M., Goudie, A., Garza, J. M., Crouch, G., & Denson, L. A. (2013). Venous thrombotic events in hospitalized children and adolescents with inflammatory bowel disease. Journal of Pediatric Gastroenterology and Nutrition, 56(5), 485-91. https://doi.org/10.1097/MPG.0b013e3182801e43
Nylund CM, et al. Venous Thrombotic Events in Hospitalized Children and Adolescents With Inflammatory Bowel Disease. J Pediatr Gastroenterol Nutr. 2013;56(5):485-91. PubMed PMID: 23232326.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Venous thrombotic events in hospitalized children and adolescents with inflammatory bowel disease. AU - Nylund,Cade M, AU - Goudie,Anthony, AU - Garza,Jose M, AU - Crouch,Gary, AU - Denson,Lee A, PY - 2012/12/13/entrez PY - 2012/12/13/pubmed PY - 2013/11/2/medline SP - 485 EP - 91 JF - Journal of pediatric gastroenterology and nutrition JO - J Pediatr Gastroenterol Nutr VL - 56 IS - 5 N2 - BACKGROUND: Adults with inflammatory bowel disease (IBD) have an increased risk of venous thrombotic events (TEs). We sought to evaluate the risk for TE in children and adolescents with IBD using a large population database. METHODS: The triennial Healthcare Cost and Utilization Project Kids' Inpatient Database was used in a retrospective cohort study of hospitalized children in the United States across 1997, 2000, 2003, 2006, and 2009. Billing codes were used to identify discharges with Crohn disease, ulcerative colitis, pulmonary embolism, deep vein thrombosis, thrombophlebitis, thrombosis of intracranial venous sinus, Budd-Chiari syndrome, and portal vein thrombosis. A logistic regression model was fitted to quantify the increased risk of TE in children with IBD, while adjusting for other risk factors of thrombosis. RESULTS: The total weighted number of pediatric discharges was 7,448,292, and 68,394 (0.92%) were identified with IBD. The incidence of any TE in a hospitalized child or adolescent with IBD was 117.9/10,000 with a relative risk (95% confidence interval) of 2.36 (2.15-2.58). The adjusted odds ratio for any TE in a patient with IBD without surgery was 1.22 (1.08-1.36). Risk factors for TE among patients with IBD include older age, central venous catheter, parenteral nutrition, and an identified hypercoagulable condition. There is an increasing trend of TE in both the IBD and non-IBD patients. CONCLUSIONS: Hospitalized children and adolescents with IBD are at increased risk for TE. Conservative methods of TE prevention including hydration, mobilization, or pneumatic devices should be considered in hospitalized patients with IBD. SN - 1536-4801 UR - https://www.unboundmedicine.com/medline/citation/23232326/Venous_thrombotic_events_in_hospitalized_children_and_adolescents_with_inflammatory_bowel_disease_ L2 - https://doi.org/10.1097/MPG.0b013e3182801e43 DB - PRIME DP - Unbound Medicine ER -