P2625 - The Risk of Venous Thromboembolism in Hospitalized Pediatric Patients with Inflammatory Bowel Diseases: A Nationwide Analysis Comparative Study

Mohammed El-Dallal, MD, MMSc¹, Ethan B. Niebergall, BS¹, Reesha Bodiwala, DO², M'hamed Turki, MD¹, Jana Sherif, BS², Xavier Villa, MD^3
1Joan C. Edwards School of Medicine, Marshall University, Huntington, WV; ²Marshall University Joan C. Edwards School of Medicine, Huntington, WV; ³Marshall University/Cabell Huntington Hospital, Huntington, WV

Introduction: Venous thromboembolism (VTE) is a serious complication of inflammatory bowel disease (IBD). While VTE risk is well-studied in adults with IBD, data on pediatric patients is limited. This study compares VTE risk between hospitalized pediatric and adult IBD patients to explore age-related differences.

Methods: The National Inpatient Sample data (2016-2020) was used, patients with IBD classified into pediatric (< 18) and adult groups to compare VTE occurrence. Differences were adjusted using inverse probability weighting, accounting for demographics, hospital characteristics, length of stay, acute kidney injury (AKI), and respiratory failure. VTE was classified into lower deep venous thrombosis (DVT), upper DVT, and pulmonary embolism (PE). A sensitivity analysis divided pediatric patients into (0-6, 7-12, and 13-17) to compare their VTE risk with adults. An interaction term analysis evaluated whether central venous catheter (CVL) placement affected VTE risk differently in pediatric vs. adult patients. Survey analysis used to account for the data sampling and weighting.

Results: Of 878,820 patients admitted with IBD (2016-2020), 45,870 were < 18. Pediatric patients had longer hospital stays, AKI, and CVL compared to adults (Table1). Unadjusted analysis indicated that pediatric patients had lower overall risk of VTE (0.8% vs. 1.4%, P< 0.001), lower extremity DVT (0.3% vs. 0.7%, P< 0.001), and PE (0.02% vs. 0.6%, P< 0.001), but a higher risk of upper extremity DVT (0.5% vs. 0.3%, P=0.04). These findings continue to hold in the adjusted model, except for lower DVT risk (Fig1.A). In age-specific analysis, children aged 0-6 did not significantly differ from adults in VTE risk (OR 0.9, 95%CI: 0.23-3.71, P=0.9), whereas those aged 7-12 and 13-17 had lower VTE odds compared to adult (Fig1.B). CVL placement increased VTE risk in both groups without significant differential impact (Fig1.C).

Discussion: This study shows that pediatric IBD patients have a lower overall VTE risk compared to adults, though they have a higher risk for upper extremity DVT. The risk varies within pediatric subgroups, with the youngest showing potentially higher VTE risk, likely influenced by a smaller sample size, warranting cautious interpretation. CVL placement increases VTE risk universally, suggesting it does not disproportionately affect one age group. These findings highlight the need for age-specific risk stratification and management strategies for VTE in IBD patients to optimize outcomes and minimize complications.



Disclosures:


Mohammed El-Dallal, MD, MMSc¹, Ethan B. Niebergall, BS¹, Reesha Bodiwala, DO², M'hamed Turki, MD¹, Jana Sherif, BS², Xavier Villa, MD³. P2625 - The Risk of Venous Thromboembolism in Hospitalized Pediatric Patients with Inflammatory Bowel Diseases: A Nationwide Analysis Comparative Study, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.