Venous Thromboembolism in Pediatric Inflammatory Bowel Disease: A Case-Control Study.

TitleVenous Thromboembolism in Pediatric Inflammatory Bowel Disease: A Case-Control Study.
Publication TypeJournal Article
Year of Publication2021
AuthorsMitchel EB, Rosenbaum S, Gaeta C, Huang J, Raffini LJ, Baldassano RN, Denburg MR, Albenberg L
JournalJ Pediatr Gastroenterol Nutr
Date Published2021 Feb 16
ISSN1536-4801
Abstract

OBJECTIVES: Inflammatory bowel disease (IBD) is associated with increased risk of venous thromboembolism (VTE). Despite this recognized risk, there are limited data and no anticoagulation guidelines for hospitalized pediatric IBD patients. The objectives of this study were to characterize pediatric IBD patients with VTE and determine risk factors.

METHODS: This was a nested case-control study comparing hospitalized children with IBD diagnosed with VTE to those without VTE over a decade at a large referral center. Standard descriptive statistics were used to describe the VTE group. Multivariable conditional logistic regression was used to assess risk factors.

RESULTS: Twenty-three cases were identified. Central venous catheter (CVC) presence (OR 77.9 (95% CI: 6.9, 880.6; p < 0.001)) and steroid use (OR 12.7 (95% CI: 1.3, 126.4; p = 0.012)) were independent risk factors. Median age at VTE was 17 years (IQR 13.5, 18.2), and in 48% VTE was the indication for admission. Median duration of anticoagulation was 3.8 months (IQR 2.3, 7.6), and there were no major bleeding events for patients on anticoagulation. There were no patients with known sequelae from VTE, though 22% had severe VTE that required interventions.

CONCLUSIONS: Pediatric patients with IBD are at risk for VTE, although the absolute risk remains relatively low. The safety and efficacy of pharmacologic thromboprophylaxis needs to be further evaluated in this population with attention to risk factors, such as steroid use and presence of CVC.

An infographic is available for this article at:http://links.lww.com/MPG/C232.

DOI10.1097/MPG.0000000000003078
Alternate JournalJ Pediatr Gastroenterol Nutr
PubMed ID33605670