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Hypercoagulation After Hospital Discharge in Acute Severe Ulcerative Colitis: A Prospective Study
Benjamin J Griffiths1, Michael J R Desborough2, Marjolijn Duijvestein3
1Translational Gastroenterology Unit, Nuffield Department of Medicine, John Radcliffe Hospital, Oxford, United Kingdom; Department of Gastroenterology, Wellington Regional Hospital, Wellington, New Zealand.
Summary
Patients with acute severe ulcerative colitis (ASUC) show elevated blood clot risk (prothrombotic state) during and after hospitalization. This heightened risk persists for up to 12 weeks post-discharge, confirming a significant venous thromboembolism concern.
Area of Science:
- Gastroenterology
- Hematology
- Clinical Medicine
Background:
- Venous thromboembolism (VTE) is a significant risk for hospitalized patients with acute severe ulcerative colitis (ASUC).
- Understanding the temporal changes in thrombotic profiles is crucial for managing VTE risk in ASUC patients.
Purpose of the Study:
- To evaluate serial thrombotic profiles in ASUC patients during hospitalization and up to 12 weeks post-discharge.
- To compare these profiles with those of patients experiencing quiescent ulcerative colitis.
Main Methods:
- Assessed thrombin generation, clot firmness (rotational thromboelastometry), procoagulant/anticoagulant factors, and fibrinolysis in 27 ASUC patients and 25 controls.
- Measurements in ASUC patients were taken on admission, Day 5, 4 weeks, and 8-12 weeks post-discharge.
Main Results:
- ASUC patients exhibited significantly elevated endogenous thrombin potential and maximum clot firmness compared to controls.
- These prothrombotic markers remained elevated for up to 12 weeks post-admission.
- Increased levels of Von Willebrand factor antigen, factor VIII, fibrinogen, and platelet count were observed in ASUC patients.
Conclusions:
- Patients with ASUC display a prothrombotic hemostatic profile compared to quiescent ulcerative colitis patients.
- This prothrombotic state persists for at least 8-12 weeks after initial presentation.
- Findings support the elevated risk of VTE in ASUC patients even after hospital discharge.
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