Prevention of central venous catheter-related infection in ICU with cluster nursing intervention: a meta-analysis

Objective:To systematically evaluate the clinical effects of cluster nursing intervention in preventing central venous catheter-related infection in intensive care unit.Methods:A randomized controlled study was searched from China National Knowledge Internet(CNKI),Wanfang,Chinese Scientific Journals Database(VIP),Chinese Biomedical Literature Service System(SinoMed),PubMed,Embase and Cochrane library databases from the establishment to May 1,2020.Two reviewers independently evaluated and cross checked the quality of the study.Revman 5.3 was used to conduct the meta-analysis.Results:A total of 21 randomized controlled trials with 6,030 patients were included.Meta-analysis showed that the incidence of central venous catheter-related infection(relative risk(RR)=0.29,95%confidence interval(CI)[0.23,0.37]),the incidence of catheter plugging(RR=0.25,95%CI[0.16,0.39])and catheter prolapse(RR=0.18,95%CI[0.11,0.29])were significantly different between the two groups.Conclusion:Cluster nursing intervention could prevent central venous catheter-related infection in intensive care unit.

Central Venous Catheter-related Thrombosis in Senile Male Patients: New Risk Factors and Predictors

Central venous catheterization（CVC）-related venous thrombosis is a common but serious clinical complication, thus prevention and treatment on this problem should be extensively investigated. In this research, we aimed to investigate the incidence rate of CVC-related venous thrombosis in senile patients and give a further discussion on the related risk factors and predictors. A total of 324 hospitalized senile male patients subjected to CVC were selected. Retrospective investigation and analysis were conducted on age, underlying diseases, clinical medications, catheterization position and side, catheter retention time, and incidence of CVC-related venous thrombosis complications. Basic laboratory test results during catheterization and thrombogenesis were also collected and analyzed. Among the 324 patients, 20 cases（6.17%） of CVC-related venous thrombosis were diagnoseds. The incidence rate of CVC-related venous thrombosis in subclavian vein catheterization was significantly lower than that in femoral vein catheterization（P〈0.01） and that in internal jugular vein catheterization（P〈0.05）. No statistically significant difference was found between femoral vein catheterization and internal jugular vein catheterization（P〉0.05）. Previous venous thrombosis history（P〈0.01）, high lactate dehydrogenase level（P〈0.01）, low high-density lipoprotein（HDL） level（P〈0.05）, and low albumin level（P〈0.05） were found as risk factors or predictors of CVC-related venous thrombosis in senile male patients. Subclavian vein catheterization was the most appropriate choice among senile patients to decrease the incidence of CVC-related venous thrombosis. Previous venous thrombosis history, high lactate dehydrogenase level, low HDL level, and low albumin level were important risk factors in predicting CVC-related venous thrombosis.

Analysis of the relationship between deep venous catheter-related infection and post-operative complications in patients receiving minimally invasive esophagectomy

Objective The aim of the study was to evaluate catheter-related infection rate(CRIR)for patients receiving minimally invasive esophagectomy(MIE),to identify the optimal catheterization approach and relationship between CRIR and post-operative complications.Methods In total,168 patients with esophageal carcinoma and undergoing MIE combined with preoperative deep venous catheterization(DVC)were analyzed in our institution(Qingdao Municipal Hospital,China),from 2014 to 2018.After completing DVC,catheter-tips together with intraductal venous blood samples were sent to the microbiology lab for bacterial strain culture.CRIR was statistically evaluated for the following clinical variables:gender,age,smoking status,drinking status,past history,tumor location,histologic grade,pathological T,N,and M category,anastomotic location,anastomotic leakage,anastomotic stricture,chylothorax,pneumonia,recurrent laryngeal nerve(RLN)injury,reflux esophagitis,catheterization site,and catheter-locking days.Results Among the 144 patients recruited in our study,105 catheters were inserted into the jugular vein and 39 catheters into the subclavian vein.The median age of these patients was 63 years(range:42–79 years),and the median catheter-locking period was seven days(range:4–21 days).Four catheters were identified with three types of strain colonizations,including Staphylococcus epidermidis,Staphylococcus aureus and Blastomyces albicans.Statistical data showed that patients diagnosed with catheter-related infection were likely to incur anastomotic leakage(66.67%,P<0.001)and pneumonia(27.27%,P<0.001);features such as tumors located in the upper esophagus(13.6%,P=0.003),and over seven catheterlocking days(10.00%,P<0.001)were attributed to a high CRIR.Conclusion Although both jugular and subclavian veins can be catheterized for patients with MIE,DVC is associated with more than seven catheter-locking days and upper esophagectomy,due to high CRIR.Furthermore,catheter-related infection is related to anastomotic leakage and pneumonia.

Clinical analysis of central venous catheter-related infections in patients in the emergency ICU

BACKGROUND:Catheter-related infection(CRI)of the central vein is a common cause of nosocomial infection.This study was undertaken to investigate the pathogen culturing and risk factors of CRI in emergency intensive care unit(EICU)in order to provide the beneficial reference.METHODS:From January 2008 to December 2010,a total of 1 363 patients were subjected to catheterization.In these patients,the peak CRI rate of the patients was determined by bacterial cultivation and blood bacterial cultivation.RESULTS:CRI happened in 147 of the 1 363 patients using the central venous catheter.The peak rate of CRI was 10.79%,with an incidence of 3.05 episodes per 1 000 catheter days.Of the147 patients,46.94%had gram-negative bacilli,40.14%had gram-positive cocci,and 12.92%had fungi.Unconditional logistic regression analysis suggests that multiple catheterization,femoral vein catheterization,the application of multicavity catheter,and the duration of catheterization were the independent risk factors for CRI.CONCLUSION:The risk factors for catheter-related infections should be controlled to prevent the occurrence of nosocomial infection.

Incidence and Predictors of Peripheral Venous Catheter-Related Complications in Hospitals in Burkina Faso

Introduction: Peripheral venous catheters (PVCs) are the most commonly used medical devices in hospitals for the administration of medications. Their use can lead to complications of varying severity. Objective: Determine the incidence and factors associated with the occurrence of PVC-related complications. Methods: This was a two-month prospective observational study conducted in the Medical Emergency Department (MED) of Yalgado Ouedraogo Teaching Hospital in Ouagadougou. All patients admitted during the study period who had a PVC inserted and removed were included in the study. Logistic regression analysis was used to identify the factors associated with the occurrence of complications. Results: In total, 459 PVCs were inserted and removed in 415 patients hospitalized at the Medical Emergency Department during the study period. The placement of 37.7% (n = 173) of PVCs resulted in complications in 131 patients (31.6%). For 644.3 days of catheterization, the incidence density was estimated at 6.5 complications per 1000 patient days. Phlebitis (24.0%), infection (5.7%), and accidental removal (2.8%) were the most frequently identified complications. The average age of the patients was 46.8 ± 18.9 years with a sex ratio of 1.22. The average patient hospitalization duration was 2.5 ± 2.6 days. In multivariate analysis, the factors significantly associated with the occurrence of complications after PVC insertion were patient’s state of agitation during the procedure (aOR = 12.59;95% CI = 4.12 - 38.49), placement of the PVC at the elbow bend (aOR = 2.17;95% CI = 1.86 - 5.52), multiple attempts (aOR = 3.18;95% CI = 1.49 - 6.75), administration of 10% hypertonic glucose solution (aOR = 3.67;95% CI = 1.62 - 8.33), and duration of catheterization beyond 72 hours without being changed (aOR = 33.00;95% CI = 14.19 - 76.75). Conclusion: The incidence of PVC-related complications was relatively high. The identification of the factors that can lead to these complications is relevant to the delivery of quality healthcare to patients.

Unveiling sinus venosus atrial septal defect and partial anomalous pulmonary venous return in an elderly patient

Sinus venosus defect(SVD) accounts for 4%–11% of all atrial septal defects(ASD) and may present with dyspnea, heart failure(HF), palpitations, or angina.^[1] The malformation typically involves an interatrial communication due to a deficiency in the common wall connecting the right pulmonary veins and the superior vena cava(SVC) and often accompanies anomalous pulmonary venous connection of some or all of the pulmonary veins.

Estimation of the Direct Cost of Management of Venous Thromboembolism in Three Reference Hospitals in the City of Yaoundé: A Retrospective Study over a Three-Year Period

Background: Venous thromboembolism (VTE) is a major public health problem due to its increasing frequency, mortality and management cost. This cost may require major financial efforts from patients, especially in developing countries like ours where less than 7% of the population has health insurance. This study aimed to estimate the direct cost of managing VTE in three reference hospitals in Yaoundé. Methods: This was a cross-sectional retrospective study over a three-year period (from January 1st 2018 to December 31 2020) carried out in the Cardiology departments of the Central and General Hospitals, and the Emergency Centre of the city of Yaoundé. All patients managed during the study period for deep vein thrombosis and pulmonary embolism confirmed by venous ultrasound coupled with Doppler and computed tomography pulmonary angiography respectively were included. For each patient, we collected sociodemographic and clinical data as well as data on the cost of consultation, hospital stay, workups and medications. These data were analysed using SPSS version 23.0. Results: A total of 92 patient’s records were analysed. The median age was 60 years [48 - 68] with a sex ratio of 0.53. The median direct cost of management of venous thromboembolism was 766,375 CFAF [536,455 - 1,029,745] or $1415 USD. Management of pulmonary embolism associated with deep vein thrombosis was more costly than isolated pulmonary embolism or deep vein thrombosis. Factors influencing the direct cost of management of venous thromboembolism were: hospital structure (p = 0.015), health insurance (p 0.001), type of pulmonary embolism (p = 0.021), and length of hospital stay (p = 0.001). Conclusion: Management of VTE is a major financial burden for our patients and this burden is influenced by the hospital structure, health insurance, type of pulmonary embolism and length of hospital stay.

Functional Capacity of Patients with Venous Thromboembolic Disease Six to Twelve Months after Treatment

Background: Venous thromboembolism (VTE) is among the leading causes of hospital-related disability-adjusted life years lost. We aimed to determine the prevalence and determinants of functional capacity impairment six to twelve months after an acute VTE event. Methods: This was a cross-sectional study conducted between January and April 2021 in two referral hospitals of Yaoundé, including consenting adult patients admitted to these hospitals six to twelve months ago for VTE. We excluded dead patients and those with any comorbidity or symptoms limiting physical activity. The functional outcome was assessed with the six-minute walk test. Functional capacity impairment was defined as walking distance lower than the expected value. Results: We included 27 cases in this study with a mean age of 53.2 ± 14.4 years. The prevalence of functional capacity impairment was 29.6% (95% CI: 14.8 - 48.1). Factors associated with poor functional outcome were obesity (OR: 59.5;95% CI: 4.6 - 767.2;p - 207.4;p = 0.017), massive PE (OR: 30;95% CI: 2.5 - 354;p = 0.004), and poor adherence to treatment (OR: 30.3;95% CI: 2.5 - 333.3;p = 0.004). Conclusion: Functional capacity impairment is common in the medium-term after VTE and factors associated with this poor outcome are obesity, the severity of the VTE, and poor adherence to treatment.

Chronic venous insufficiency, could it be one of the missing pieces in the puzzle of treating pain?

Pain is a common complaint among patients seeking medical care.If left un-treated,pain can become chronic,significantly affecting patients’quality of life.An accurate diagnosis of the underlying cause of pain is crucial for effective treatment.Chronic venous insufficiency(CVI)is frequently overlooked by pain physicians.Moreover,many pain physicians lack sufficient knowledge about CVI.CVI is a common condition resulting from malfunctioning or damaged valves in lower limb veins.Symptoms of CVI,ranging from mild to severe,include pain,heaviness,fatigue,itching,swelling,skin color changes,and ulcers in the lower limbs.Recently,it has become more widely known that these symptoms can be attributed to CVI.Even slight or mild CVI can cause related symptoms.Pain physicians primarily consider neuromusculoskeletal disorders when assessing patients with leg pain,and often neglect the possibility of CVI.In clinical practice,when pain physicians encounter patients with unresolved leg pain,they must assess whether the patients exhibit symptoms of CVI and conduct tests to differ-entiate CVI from other potential causes.

Genetic risk stratification of inflammatory bowel disease-associated venous thromboembolism:An Asian perspective

The utilisation of polygenic scoring models may enhance the clinician’s ability to risk stratify an inflammatory bowel disease patient’s individual risk for venous thromboembolism(VTE)and guide the appropriate usage of VTE thromboprophylaxis,yet there is a need to validate such models in ethnically diverse populations.

Utility of plasma D-dimer for diagnosis of venous thromboembolism after hepatectomy

BACKGROUND Venous thromboembolism(VTE)is a potentially fatal complication of hepatectomy.The use of postoperative prophylactic anticoagulation in patients who have undergone hepatectomy is controversial because of the risk of postoperative bleeding.Therefore,we hypothesized that monitoring plasma D-dimer could be useful in the early diagnosis of VTE after hepatectomy.AIM To evaluate the utility of monitoring plasma D-dimer levels in the early diagnosis of VTE after hepatectomy.METHODS The medical records of patients who underwent hepatectomy at our institution between January 2017 and December 2020 were retrospectively analyzed.Patients were divided into two groups according to whether or not they developed VTE after hepatectomy,as diagnosed by contrast-enhanced computed tomography and/or ultrasonography of the lower extremities.Clinicopathological factors,including demographic data and perioperative D-dimer values,were compared between the two groups.Receiver operating characteristic curve analysis was performed to determine the D-dimer cutoff value.Univariate and multivariate analyses were performed using logistic regression analysis to identify significant predictors.RESULTS In total,234 patients who underwent hepatectomy were,of whom(5.6%)were diagnosed with VTE following hepatectomy.A comparison between the two groups showed significant differences in operative time(529 vs 403 min,P=0.0274)and blood loss(530 vs 138 mL,P=0.0067).The D-dimer levels on postoperative days(POD)1,3,5,7 were significantly higher in the VTE group than in the non-VTE group.In the multivariate analysis,intraoperative blood loss of>275 mL[odds ratio(OR)=5.32,95%confidence interval(CI):1.05-27.0,P=0.044]and plasma D-dimer levels on POD 5≥21μg/mL(OR=10.1,95%CI:2.04-50.1,P=0.0046)were independent risk factors for VTE after hepatectomy.CONCLUSION Monitoring of plasma D-dimer levels after hepatectomy is useful for early diagnosis of VTE and may avoid routine prophylactic anticoagulation in the postoperative period.

Protein C deficiency with venous and arterial thromboembolic events

Protein C(PC)is a key component of the vitamin K-dependent coagulation pathway.It exerts anticoagulant effects by inactivating factors V and VIII.Acquired or inherited PC deficiency results in a prothrombotic state,with presentations varying from asymptomatic to venous thromboembolism.However,there has been an increasing number of reports linking PC deficiency to arterial thromboembolic events,such as myocardial infarction and ischemic stroke.This editorial focuses on the association between PC deficiency and thromboembolism,which may provide some insights for treatment strategy and scientific research.

Research progress on venous thrombosis development in patients with malignant tumors

The coexistence of venous thromboembolism(VTE)within patients with cancer,known as cancer-associated thrombosis(CAT),stands as a prominent cause of mortality in this population.Over recent years,the incidence of VTE has demonstrated a steady increase across diverse tumor types,influenced by several factors such as patient management,tumor-specific risks,and treatment-related aspects.Furthermore,mutations in specific genes have been identified as potential contributors to increased CAT occurrence in particular cancer subtypes.We conducted an extensive review encompassing pivotal historical and ongoing studies on CAT.This review elucidates the risks,mechanisms,reliable markers,and risk assessment methodologies that can significantly guide effective interventions in clinical practice.

Use of MLC901 in cerebral venous sinus thrombosis:Three case reports

BACKGROUND Cerebral venous sinus thrombosis(CVT)is rare cause of cerebrovascular disease.The incidence is 0.5%of all stroke.The majority of affected patients are young adults(mean age:35-40 years)with mild to moderate disabilities.Poor outcome with severe disability is seen in 13%of cases.Early diagnosis and treatment are important for good outcomes and preventing complications.Treatment options are limited and mostly based on consensus.NeuroAiD II™(MLC901;Moleac Pte,Ltd,Singapore)has a potential beneficial role in post-stroke recovery,by aiding the natural brain recovery process.CASE SUMMARY MLC901 consists of nine natural herbal ingredients.Studies have shown its safety profile and aid in post stroke recovery.The aim of this case series was to demonstrate the potential role of MLC901 in stroke recovery of patients with cerebral venous sinus thrombosis(CVST)who received MLC901 in addition to standard of care.The prescribed dose of MLC901 is 400 mg/cap two capsules,three times a day.Data from these patients were prospectively collected at baseline and at monthly visits,for a duration of 3 mo.Outcome measures included adherence to therapy,side effects,National Institutes of Health Stroke Scale,Glasgow Coma Scale,modified Rankin Scale,and the Short Orientation-Memory-Concentration Test.MLC901 was well tolerated and no side effects were reported.All patients were stable with improved condition.CONCLUSION This case series highlights the potential therapeutic effects of MLC901 on CVST and provides support for further studies.

Venous Doppler flow patterns,venous congestion,heart disease and renal dysfunction:A complex liaison

The World Journal of Cardiology published an article written by Kuwahara et al that we take the pleasure to comment on.We focused our attention on venous congestion.In intensive care settings,it is now widely accepted that venous congestion is an important clinical feature worthy of investigation.Evaluating venous Doppler profile abnormalities at multiple sites could suggest adequate treatment and monitor its efficacy.Renal dysfunction could trigger or worsen fluid overload in heart disease,and cardio-renal syndrome is a well-characterized spectrum of disorders describing the complex interactions between heart and kidney diseases.Fluid overload and venous congestion,including renal venous hypertension,are major determinants of acute and chronic renal dysfunction arising in heart disease.Organ congestion from venous hypertension could be involved in the development of organ injury in several clinical situations,such as critical diseases,congestive heart failure,and chronic kidney disease.Ultrasonography and abnormal Doppler flow patterns diagnose clinically significant systemic venous congestion.Cardiologists and nephrologists might use this valuable,noninvasive,bedside diagnostic tool to establish fluid status and guide clinical choices.

Multiple paradoxical embolisms caused by central venous catheter thrombus passing through a patent foramen ovale: A case report

BACKGROUND To date,this is the first case of a paradoxical embolism(PDE)that concurrently manifested in the coronary and lower limb arteries and was secondary to a central venous catheter(CVC)thrombus via a patent foramen ovale(PFO).CASE SUMMARY Here,we report a case of simultaneous coronary and lower limb artery embolism in a PFO patient carrier of a CVC.The patient presented to the hospital with acute chest pain and lower limb fatigue.Doppler ultrasound showed a large thrombus in the right internal jugular vein,precisely at the tip of the CVC.Transthoracic and transesophageal echocardiography confirmed the existence of a PFO,with inducible right-to-left shunting by the Valsalva maneuver.The patient was administered an extended course of anticoagulation therapy,and then the CVC was successfully removed.Percutaneous PFO closure was not undertaken.There was no recurrence during follow-up.CONCLUSION Thus,CVC-associated thrombosis is a potential source for multiple PDE in PFO patients.

Point-of-care ultrasonography spotlight:Could venous excess ultrasound serve as a shared language for internists and intensivists?

Point-of-care ultrasonography(POCUS),particularly venous excess ultrasound(VExUS)is emerging as a valuable bedside tool to gain real-time hemodynamic insights.This modality,derived from hepatic vein,portal vein,and intrarenal vessel Doppler patterns,offers a scoring system for dynamic venous congestion assessment.Such an assessment can be crucial in effective management of patients with heart failure exacerbation.It facilitates diagnosis,quantification of congestion,prognostication,and monitoring the efficacy of decongestive therapy.As such,it can effectively help to manage cardiorenal syndromes in various clinical settings.Extended or eVExUS explores additional veins,potentially broadening its applications.While VExUS demonstrates promising outcomes,challenges persist,particularly in cases involving renal and liver parenchymal disease,arrhythmias,and situations of pressure and volume overload overlap.Proficiency in utilizing spectral Doppler is pivotal for clinicians to effectively employ this tool.Hence,the integration of POCUS,especially advanced applications like VExUS,into routine clinical practice necessitates enhanced training across medical specialties.

Emphysematous thrombophlebitis caused by a misplaced central venous catheter: A case report

BACKGROUND Central venous catheters(CVCs)often cause life-threatening complications,especially CVC-related bloodstream infection(CVC-BSI)and catheter-related thrombosis(CRT).Here,we report an unusual case of misplaced CVC-induced emphysematous thrombophlebitis,a rare but potentially lethal form of CRT and CVC-BSI characterized by both thrombosis and gas formation.CASE SUMMARY A 48-year-old male presented to the emergency room of a local hospital with sudden-onset headache and coma for 4 h.Computed tomography(CT)revealed right basal ganglia hemorrhage,so emergency decompressive craniotomy was performed and a CVC was inserted through the right subclavian vein for fluid resuscitation during anesthesia.Two days later,the patient was transferred to the intensive care unit of our hospital for further critical care.On day 9 after CVC insertion,the patient suddenly developed fever and hypotension.Point-of-care ultrasound(POCUS)demonstrated thrombosis and dilatation of the right internal jugular vein(IJV)filled with thrombosis.Ultrasonography also revealed that the CVC tip had been misplaced into the IJV and was surrounded by gas bubbles,which manifested as hyperechoic lines with dirty shadowing and comet-tail artifacts.Further CT scan confirmed air bubbles surrounding the CVC in the right neck.The final diagnosis was septic emphysematous thrombophlebitis induced by a misplaced CVC and ensuing septic shock.The responsible CVC was removed immediately.The patient received fluid resuscitation,intravenous noradrenaline,and a 10-d ultra-broad spectrum antibiotic treatment to combat septic shock.Both CVC and peripheral venous blood cultures yielded methicillin-resistant Staphylococcus cohnii.The patient was gradually weaned off vasopressors and the symptoms of redness and swelling in the right neck subsided within 7 d.CONCLUSION Emphysematous thrombophlebitis is a fulminant and life-threatening CVC-BSI associated with thrombosis and gas formation in the vein.A misplaced CVC may facilitate the development of emphysematous thrombophlebitis.POCUS can easily identify the artifacts produced by gas and thrombosis,facilitating rapid diagnosis at the bedside.

Sports compression garments improve resting markers of venous return and muscle blood flow in male basketball players

Background:The benefits associated with sports compression garments are thought to be closely related to enhanced blood flow.However,findings are equivocal,possibly due to heterogeneity in the techniques used for measuring blood flow,the garment types used,and the pressures applied.This study combined Doppler ultrasound and near-infrared spectroscopy technologies to provide the first comprehensive assessment of the effects of 3 sports compression garment types on markers of venous return and muscle blood flow at rest.Methods:Resting lower-limb blood flow measures(markers of venous return,muscle blood flow,and muscle oxygenation)of 22 elite,junior,male basketball players(age=17.2±0.9 years,mean±SD)were assessed in 4 separate conditions:no compression(CON),compression tights(TIGHTS),compression shorts(SHORTS),and compression socks(SOCKS).Markers of venous return(cross-sectional area,time-averaged mean and peak blood flow velocity,and venous blood flow)were measured via Doppler ultrasound at the popliteal and common femoral veins.Muscle blood flow and muscle oxygenation were measured in the gastrocnemius medialis and vastus lateralis using near-infrared spectroscopy.Results:Popliteal markers of venous return were higher in TIGHTS compared to CON(p<0.01)and SHORTS(p<0.01),with SOCKS values higher compared with CON(p<0.05).Common femoral vein markers of venous return were higher for all conditions compared to CON(p<0.05),with TIGHTS values also higher compared to SOCKS(p<0.05).Gastrocnemius medialis blood flow was higher for TIGHTS compared to CON(p=0.000),SOCKS(p=0.012),and SHORTS(p=0.000),with SOCKS higher compared to SHORTS(p=0.046).Vastus lateralis blood flow was higher for TIGHTS compared to CON(p=0.028)and SOCKS(p=0.019),with SHORTS also higher compared to CON(p=0.012)and SOCKS(p=0.005).Gastrocnemius medialis oxygenation was higher for TIGHTS compared to CON(p=0.003),SOCKS(p=0.033),and SHORTS(p=0.003),with SOCKS higher compared to CON(p=0.044)and SHORTS(p=0.032).Vastus lateralis oxygenation was higher for TIGHTS compared to CON(p=0.020)and SOCKS(p=0.006).Conclusion:Markers of venous return,muscle blood flow,and muscle oxygenation are increased with sports compression garments.TIGHTS are most effective,potentially because of the larger body area compressed.

Risk assessment of venous thromboembolism in inflammatory bowel disease by inherited risk in a population-based incident cohort

Inflammatory bowel disease(IBD),including Crohn’s disease(CD)and ulcerative colitis(UC),is a chronic inflammatory disease of the digestive tract with increasing prevalence globally.Although venous thromboembolism(VTE)is a major complication in IBD patients,it is often underappreciated with limited tools for risk stratification.AIM To estimate the proportion of VTE among IBD patients and assess genetic risk factors(monogenic and polygenic)for VTE.METHODS Incident VTE was followed for 8465 IBD patients in the UK Biobank(UKB).The associations of VTE with F5 factor V leiden(FVL)mutation,F2 G20210A prothrombin gene mutation(PGM),and polygenic score(PGS003332)were tested using Cox hazards regression analysis,adjusting for age at IBD diagnosis,gender,and genetic background(top 10 principal components).The performance of genetic risk factors for discriminating VTE diagnosis was estimated using the area under the receiver operating characteristic curve(AUC).RESULTS The overall proportion of incident VTE was 4.70%in IBD patients and was similar for CD(4.46%),UC(4.49%),and unclassified(6.42%),and comparable to that of cancer patients(4.66%)who are well-known at increased risk for VTE.Mutation carriers of F5/F2 had a significantly increased risk for VTE compared to non-mutation carriers,hazard ratio(HR)was 1.94,95%confidence interval(CI):1.42-2.65.In contrast,patients with the top PGS decile had a considerably higher risk for VTE compared to those with intermediate scores(middle 8 deciles),HR was 2.06(95%CI:1.57-2.71).The AUC for differentiating VTE diagnosis was 0.64(95%CI:0.61-0.67),0.68(95%CI:0.66-0.71),and 0.69(95%CI:0.66-0.71),respectively,for F5/F2 mutation carriers,PGS,and combined.CONCLUSION Similar to cancer patients,VTE complications are common in IBD patients.PGS provides more informative risk information than F5/F2 mutations(FVL and PGM)for personalized thromboprophylaxis.