Abstract Background Patients (pts) with inflammatory bowel disease (IBD) have a significantly higher risk of venous thromboembolic events (VTEs) compared to the general population 1. Thromboprophylaxis (TP) is recommended for IBD pts during all-cause hospitalisation 2. Evidence supporting this practice in the clinical context of IBD is scarce. This retrospective, real-world, single-centre study aims to evaluate the effectiveness and safety of TP in preventing VTEs in a large cohort of hospitalised IBD pts. The secondary endpoint of the study was to measure adherence to TP prescription. Methods Disease-related real-world data were retrospectively collected from the Hospital Information System using automated data extraction strategies and through the implementation of a patient-centred data repository 3. The study population was identified from the medical records of 2020-2023 hospitalised patients aged ≥18 years, diagnosed with IBD. Variables of interest, including demographics, comorbidities, surgery procedures, and treatment information, were collected. The TP included one of the following therapeutic protocols: low-molecular-weight heparin at a dose of 4000 to 8000 IU/day, fondaparinux 2.5-3.5 mg/day, or calciparin up to 5000 IU twice daily. Results Of the 1359 identified IBD pts (42% with UC), 724 (53.3%) received anticoagulants during hospitalisation. 77 pts (5.8%) had a VTE. After excluding from the analysis pts already in treatment with anticoagulants before hospitalisation and pts initiating a therapeutic dose of anticoagulant immediately after admission (meaning they already had a VTE at admission), 1067 patients were evaluated for the efficacy of TP in preventing VTEs during hospitalisation. The overall incidence of VTE showed no significant difference between the TP group and the non-TP group (p = 0.374); however, VTE incidence resulted significantly higher in the group receiving TP after the second day of admission compared to those receiving TP within the second day of admission (13 vs 1.7%, p 0.001). TP was a safe strategy, as we did not observe a significant difference in the need for blood transfusions (p = 0.37) and TP interruption was rare (6.5%). In multivariate logistic regression analysis, only delayed TP remained an independent risk factor (adjusted OR: 6.07; 95% CI: 2.36–15.12). Conclusion TP is effective in a real-world cohort of hospitalised patients with IBD in reducing VTEs when prophylaxis is initiated early. It is also safe as it does not increase the risk of severe bleeding requiring blood transfusions, and treatment discontinuation is an infrequent event. However, the rate of TP in our cohort is still suboptimal, and strategies to implement this practice are recommended to further reduce VTE occurrence. References: 1. Papa A, Gerardi V, Marzo M, et al. Prevention and treatment of venous thromboembolism in patients with IBD: a trail still climbing. Inflamm Bowel Dis. 2015;21(5):1204-1213. 2. Olivera PA, Zuily S, Kotze PG, et al. International consensus on preventing venous and arterial thrombotic events in patients with inflammatory bowel disease. Nat Rev Gastroenterol Hepatol. 2021;18(12):857-873. 3. Damiani A, Mastronardi M, Laterza D, et al. Building an artificial intelligence laboratory based on real-world data: the experience of Gemelli Generator. Front Comput Sci. 2021;3:1-10. Conflict of interest: Laterza, Lucrezia: No conflict of interest Di Giorgi, Nicoletta: No conflict of interest Masciocchi, Carlotta: No conflict of interest Iacomini, Chiara: No conflict of interest Cuccia, Giuseppe: No conflict of interest Iaccarino, Jacopo: No conflict of interest Puca, Pierluigi: No conflict of interest Dr. Coppola, Gaetano: No conflict of interest Colantuono, Stefania: No conflict of interest Lopetuso, Loris Riccardo: No conflict of interest Patarnello, Stefano: No conflict of interest Scaldaferri, Franco: No conflict of interest Gasbarrini, Antonio: No conflict of interest Papa, Alfredo: No conflict of interest
Laterza et al. (Thu,) studied this question.