VENOUS THROMBOEMBOLISM AND INPATIENT OUTCOMES IN INFLAMMATORY BOWEL DISEASE: EVIDENCE FROM THE NATIONWIDE INPATIENT SAMPLE

Abstract BACKGROUND Venous thromboembolism (VTE) is a widely acknowledged complication in inflammatory bowel disease (IBD). However, current national estimates of its effect on hospitalization outcomes have not been well established. METHODS We analyzed the 2020–2022 Nationwide Inpatient Sample (NIS) to identify adult IBD admissions using ICD-10 codes, excluding pregnancy and malignancy. VTE was defined by validated ICD-10 codes. The primary outcomes were inpatient mortality, discharge disposition, length of stay (LOS), and hospitalization costs. Survey-weighted descriptive statistics and multivariable regression models adjusted for demographics, comorbidities, admission characteristics, and hospital characteristics were performed. RESULTS A total of 165,292 weighed IBD admissions were observed, of which 4.2% had VTE. Compared with non-VTE admissions, patients with VTE experienced longer mean LOS (11.0 vs. 5.4 days), higher mean costs ($150,470 vs. $67,140), higher inpatient mortality (6.3% vs. 1.8%), and a greater proportion of non-home discharges (43.8% vs. 29.0%) (all P < 0.001). In adjusted analyses, VTE was independently associated with more than a threefold increase in inpatient mortality (adjusted odds ratio [aOR] 3.16, 95% CI 2.83–3.53), nearly doubled odds of discharge to facility (aOR 1.82, 95% CI 1.72–1.93), a twice as high increase in LOS (incidence rate ratio 1.97, 95% CI 1.91–2.04), and more than doubled hospitalization costs (cost ratio 2.18, 95% CI 2.08–2.29). CONCLUSIONS VTE Is associated with substantial clinical and economic burden between hospitalized IBD patients, with significantly higher mortality, greater resources utilization, and rates of non-home discharge. These results highlight the importance of targeted inpatient thromboprophylaxis and management approaches in this specific population.