Issue 03

Clinical Question

What are the recommendations concerning prevention of venous thromboembolism in patients with IBD?

Editor’s Bottom Line

This Canadian study details many aspects of venous thromboembolism in patients with IBD.

Below we have highlighted 3 core circumstances where anticoagulant thromboprophylaxis should be used.

Reference

Nguyen GC, Bernstein CN, Bitton A, et al. Consensus statements on the risk, prevention, and treatment of venous thromboembolism in inflammatory bowel disease: Canadian Association of Gastroenterology. Gastroenterology. 2014 Mar;146(3):835–848.e6.  https://www.ncbi.nlm.nih.gov/pubmed/24462530

Synopsis

In general, IBD patients have a 3-fold increased risk for the development of venous thromboembolism (VTE) compared to those without IBD.

There is good evidence to support the use of anticoagulant thromboprophylaxis for IBD patients in the following circumstances:

•  Undergoing major surgery including abdominal and Cesarean procedures

•  Hospitalized for an IBD flare or for non-flare reasons

•  As an outpatient with an IBD flare if there is a previous history of VTE.

Details

Study Design: Review of American College of Chest Physicians (ACCP) guidelines and consensus statements
Funding: AbbVie Canada and Warner Chilcott
Allocation: n/a
Setting: n/a
Level of Evidence: 1a (Oxford Levels of Evidence)

The summary and conclusion in this issue of E-mentoring in IBD pertains to the manuscript(s) being reviewed, and should be considered in the context of what is already known surrounding the topic and incorporated into practice as deemed appropriate by the individual learner.