P1148 The incidence and predictive factors of thromboembolism during hospitalizations for IBD flare-ups: A retrospective cohort study in Taiwan

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Abstract Background Thromboembolism (TE) notably increase morbidity and mortality among inflammatory bowel disease (IBD) patients. Despite ECCO's 2024 guidelines advocating routine anticoagulant prophylaxis, its application in Asia remains inconsistent due to a lack of regional studies. This research investigates the incidence and predictors of TE during IBD-related hospitalizations in Taiwan, aiming to improve prevention strategies. Methods Our retrospective cohort study included 282 adult IBD patients, accounting for 515 flare-up related hospitalizations at Linkou Chang Gung Memorial Hospital from January 2001 to March 2024. Patients were classified into two groups based on the occurrence of TE. Numerical data were presented as means ± standard deviations, and categorical data were expressed as absolute numbers and percentages. Data analysis involved chi-square or Fisher's test for categorical variables and the Mann-Whitney U test for continuous variables. Multivariable logistic regression was utilized to identify independent predictors of TE. The cutoff values for serum albumin were determined using receiver operating characteristic (ROC) curves. Statistical significance was set at P < 0.05. All statistical analyses were performed using IBM SPSS Statistics version 26.0 (IBM Corp., Armonk, NY, USA). Results The incidence of TE was 1.55%. The TE group had significantly lower body weight (p=0.02), body mass index (BMI) (p=0.019), hemoglobin (p=0.036), and albumin levels (p=0.001) but higher rate of sepsis (p=0.002) and concurrent autoimmune diseases (p=0.002) compared to the non-TE group. Multivariate analysis indicated that concurrent autoimmune diseases (OR: 0.001, 95% CI: 0.000-0.317, p=0.02) and hypoalbuminemia (OR: 0.031, 95% CI: 0.001-0.643, p=0.025) were independent predictors of TE. (Table 1) The optimal serum albumin cutoff was established at 3.01 g/dL, with sensitivities and specificities of 87.5% and 77.3%, respectively. (Figure 1) Conclusion This pioneering Asian study identifies concurrent autoimmune diseases and low serum albumin (< 3.01g/dL) as independent predictors of TE in hospitalized IBD patients. Prophylactic anticoagulant should be considered for this high-risk group of Asian IBD inpatients.