Meta-analysis: the risk of venous thromboembolism in patients with inflammatory bowel disease

Aliment Pharmacol Ther. 2013 May;37(10):953-62. doi: 10.1111/apt.12294. Epub 2013 Apr 2.


Background: Inflammatory bowel disease (IBD), which includes Crohn's disease (CD) and ulcerative colitis (UC), is a systemic disorder that predominantly affects the bowels but is also associated with venous thromboembolism (VTE).

Aim: To provide a quantitative assessment of the association of IBD with venous thromboembolism risk and to explore the possible sources of heterogeneity in the current literature, a meta-analysis of case-control and cohort studies was conducted.

Methods: Studies were identified by a literature search of the PubMed and Scopus databases (from inception inclusive 31 December 2012) for English language studies. Summary relative risks (RRs) with 95% confidence intervals (CIs) were calculated with fixed- and random-effects models. Several subgroup analyses were performed to explore potential study heterogeneity and bias.

Results: Eleven studies met our inclusion criteria. The summary RR for deep venous thromboembolism (DVT) and pulmonary embolism (PE) comparing subjects both with and without IBD was 2.20 (95% CI 1.83-2.65). After adjusting for obesity and smoking, summary relative risks near 2.0 were seen for venous thromboembolism in both UC and CD patients.

Conclusion: This meta-analysis showed that inflammatory bowel disease is associated with an approximately two-fold increase in the risk of venous thromboembolism.

Publication types

  • Meta-Analysis

MeSH terms

  • Case-Control Studies
  • Cohort Studies
  • Confidence Intervals
  • Humans
  • Inflammatory Bowel Diseases / complications*
  • Obesity / complications
  • Pulmonary Embolism / etiology*
  • Risk Factors
  • Smoking / adverse effects
  • Venous Thromboembolism / etiology*