Thrombotic Complications in Inflammatory Bowel Disease: The Role of Coagulation Markers and Family History

Background: Inflammatory bowel disease (IBD) is a chronic inflammatory disorder characterized mainly by intestinal pathology. The risk of thrombosis increases in IBD patients, increasing overall disease morbidity and mortality. We aim to investigate the role of coagulation markers in determining the risk of thrombotic complications in IBD patients compared to healthy controls.

Methods: The study was approved by the institutional review board. All patients aged 16 or over, diagnosed with IBD and followed at our center from January 2012 -2022, were included. We investigated the family history and the hemostatic profiles of these patients. Descriptive statistics were computed for continuous variables, including means, standard deviations (SDs), minimum and maximum values, as well as 95% confidence intervals (CIs), where appropriate, and frequencies for categorical variables. Fisher exact test was used for categorical variables. Student t-test was used for continuous variables.

Results: A total of 100 patients were included in the study, comprising of 51 (24%) females and 158 (76%) males. 73% of patients were diagnosed with Crohn's disease (CD), and 27% with ulcerative colitis (UC). Deep vein thrombosis (DVT) was observed in 5 (2.3%) of patients. In patients with a family history of DVT, 1.9% had developed a thrombotic event. Among continuous variables, prothrombin time, thrombin clotting time, and fibrinogen levels had mean values significantly different for patients with thrombosis than those without thrombosis ( p-values 0.01, 0.01, and 0.03, respectively).

Conclusions: Patients with both UC and CD are at an increased risk of thrombosis. A family history of IBD can increase the risk of these events. The coagulation markers, including PT, TTC, and fibrinogen levels, can be used as biomarkers to predict the risk of thrombosis and the evaluation of the hemostatic profiles of IBD patients regularly, which can help prevent serious thrombotic complications and thus reduce morbidity and mortality resulting from these events. Therefore, such evaluation should be included in the routine examination protocols of high-risk IBD patients. This study may help better understand the biology of disease.