Incidence and risk factors for thromboembolic events in pediatric-onset inflammatory bowel disease: A French population-based study

Introduction: Patients with inflammatory bowel disease (IBD) are at higher risk of thromboembolic events (TE). In pediatric-onset IBD, more data on incidence and risk factors of venous (VTE) and arterial events (ATE) at the population level are needed to guide thromboprophylaxis. Methods: All patients aged <= 16 years diagnosed with Crohn's disease (CD) or ulcerative colitis (UC) between 1988 and 2011 in the prospective EPIMAD population-based registry were followed until 2013. Every TE occurring during the follow-up period was included. Results: A total of 1,344 patients were included: 1,007 with CD and 337 with UC, and a median diagnosis age of 14.3 years. After a median follow-up of 8.3 years, 2 (0.15 %) ATE and 15 (1.1 %) VTE occurred at median age of 20.4 years. The global incidence rate of thromboembolic events was 1.32 per 10 0 0 person- years. Periods of active disease (HR = 8.4, p = 0.0 0 02), the 3-month-period following surgery (HR = 16.4, p = 0.0 0 02) and hospitalization (HR = 21.7, p < 0.0 0 01) were found to be associated with an increased risk of VTE. A lower rate of VTE was found in patients treated with 5-aminosalicylates (HR = 0.1, p = 0.002). Conclusion: The risk of TE was low in this population. VTE were strongly associated with active disease, surgery and hospitalization. (c) 2024 The Author(s). Published by Elsevier Ltd on behalf of Editrice Gastroenterologica Italiana S.r.l. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/)