A204 THE EARLY POST-DISCHARGE PERIOD IS A VULNERABLE PERIOD FOR VENOUS THROMBOEMBOLISM IN PATIENTS WITH INFLAMMATORY BOWEL DISEASE.
Bibliographic record
Abstract
Abstract Background Patients with inflammatory bowel disease (IBD) have an increased risk of venous thromboembolism (VTE). The temporal relationship between VTE and hospitalization is poorly understood. Aims To determine the proportion of VTE events that are associated with hospitalization in patients with IBD. Methods We performed a retrospective cohort study of individuals with Crohn’s disease or Ulcerative Colitis (UC) who developed a VTE between January 1, 2009 and December 31, 2024 at a Canadian academic institution, the Ottawa Hospital. Patients with IBD and VTE events were identified by ICD-10 codes and confirmed with chart review. VTE events were categorized as ambulatory or hospital-associated (within the hospital admission or 90 days of discharge). To account for diagnostic delay at the time of hospitalization, VTE events within 48 hours of admission were categorized as ambulatory events. We determined demographics, comorbidities, medication exposure, anticoagulation and IBD disease activity at the time of VTE diagnosis. Differences between cohorts was determined using Chi-squared or Fisher’s exact test where appropriate. Results We identified 275 IBD patients with a VTE event: mean age (SD) was 55 (15.8),132 (48%) female,168 (62%) CD and 103 (38%) UC. The types of VTE included: 49% pulmonary embolism (PE) ± deep vein thrombosis (DVT), 24% DVT alone, 13% portal vein thrombosis and 14 % other VTE (splenic vein, hepatic vein, superior mesenteric vein, cerebral venous sinus). A total of 150 (55%) VTE events were categorized as hospital associated (33 patients (22%) during hospitalization and 117 patients (78%) within 90 days after hospital discharge). 30% of patients in the ambulatory category and 71% of patients in the hospital-associated category (94% during hospitalization and 30% after hospital discharge) were receiving anticoagulation (prophylaxis or therapeutic) prior to the VTE diagnosis. Patients in the hospital-associated category were significantly more likely to have a current malignancy (p=0.01), a severe flare of UC (p=0.008) and receive corticosteroids (p=0.002). There were no differences between cohorts in age, sex, comorbidities, smoking status and anti-TNF exposure. Conclusions Our study demonstrates that a large percentage of VTE events in patients with IBD are hospital-associated with the majority occurring early after hospital discharge. Importantly, only a minority of patients received VTE prophylaxis during this period, suggesting the post-discharge period is a vulnerable time for patients with IBD. Funding Agencies None
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".