Inflammatory bowel disease may increase risk of venous thromboembolism in children

1. Children living with inflammatory bowel disease (IBD) are at greater risk of venous thromboembolism (VTE) compared to children without VTE, with the highest risk occurring around time of diagnosis. 

Evidence Rating Level: 2 (Good)

Evidence from recent studies suggest that children living with IBD are at greater risk of VTE compared to children without IBD. However, due to the rarity of VTE in IBD patients in spite of this increased risk, studies have been limited to a lower number of events, making it difficult to characterize VTE risk in children beyond incidence rates. This study therefore sought to characterize children with IBD who develop VTE and to calculate absolute and relative risks compared to the general population. Patients under the age of 18 with IBD between 2001 and 2019 were identified via HES, a nationwide administrative database of all hospitals in England. A comparator cohort was constructed using data from children without IBD from the Office for National Statistics as well as HES data. The absolute risk of VTE in the general pediatric population was 0.18 (95% confidence interval [CI], 0.18-0.19) per 10,000 patient-years, while it was 9.42 (95% CI, 7.4-11.4) per 10 000 patient-years for pediatric patients living with IBD. Among children living with IBD, there was an overall relative risk increase of 51.8 (95% CI, 41.8-64.3) compared to children without IBD. When analyzing based on demographic factors, children with ulcerative colitis were at a higher risk for VTE compared to children with Crohn’s disease (incidence rate 12.4 vs 5.6 per 10 000 patient-years). Among children with IBD and VTE, 65 (76.5%) developed a VTE either within the first year following IBD diagnosis or 6 months prior to IBD diagnosis. Overall, this study found that children living with IBD are at increased risks of developing a VTE, with the greatest risk occurring around the time of diagnosis.

Click to read the study in the study in Inflammatory Bowel Disease 

Image: PD

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