Alkim et al identified risk factors for venous thromboembolism in a patient with inflammatory bowel disease (IBD). These can help to identify a patient who may benefit from antithrombotic therapy during periods of increased risk. The authors are from Sisli Hamidiye Etfal Training and Research Hospital in Istanbul.
Patient selection: inflammatory bowel disease (IBD)
A patient with IBD is at increased risk for thromboembolism related to:
(1) disease flare-up and active disease (related to increased inflammation)
(2) surgery
(3) therapy, including corticosteroids
(4) antiphospholipid antibodies
Additional triggers:
(1) immobilization, including long distance air travel
(2) central line
(3) dehydration
Additional risk factors:
(1) familial or hereditary risk factors
(2) obesity
(3) malignancy
(4) hyperhomocysteinemia
(5) increasing age
(6) pregnancy or oral contraceptives in a woman
(7) drugs given for other conditions
(8) smoking
Management decisions related to thromboembolism in a patient with IBD may range from:
(1) avoidance of risk factors
(2) prophylaxis during periods of increased risk
(3) continuous prophylaxis in high risk patients
