Persistent Prothrombotic State Observed in Patients With ASUC
Patients with acute severe ulcerative colitis remain at elevated risk for venous thromboembolism for up to 12 weeks following hospital admission, according to results of a recent study published in Inflammatory Bowel Disease.
Venous thromboembolism (VTE) is a well-recognized complication of acute severe ulcerative colitis (ASUC), particularly during hospitalization. However, the duration of thrombotic risk following discharge has remained uncertain. A prospective study evaluated serial thrombotic profiles in patients hospitalized with ASUC compared with patients with quiescent ulcerative colitis, assessing whether a prothrombotic state persists beyond the acute episode.
The study enrolled 27 patients with ASUC and 25 control patients with quiescent ulcerative colitis. Global and specific hemostatic measures were assessed. Patients with ASUC underwent serial evaluations on admission (Day 1), Day 5, Week 4, and Week 8–12. Assessments included thrombin generation (endogenous thrombin potential), rotational thromboelastometry (EXTEM and FIBTEM maximum clot firmness), procoagulant and anticoagulant factors, and fibrinolytic markers. Controls underwent a single evaluation.
Patients with ASUC demonstrated significantly elevated endogenous thrombin potential and maximum clot firmness at admission compared with controls. These prothrombotic measures remained significantly increased at 4 weeks and up to 12 weeks post-hospitalization (P < .05). Further analysis showed persistent elevation of von Willebrand factor antigen, factor VIII, Clauss fibrinogen concentration, and platelet count from presentation through 8–12 weeks. These abnormalities likely contributed to the sustained prothrombotic profile.
The findings highlight that patients with ASUC exhibit a durable prothrombotic state extending well beyond hospitalization. This supports clinical observations of increased VTE risk in the postdischarge period. The study underscores the importance of continued vigilance in thromboprophylaxis strategies for ASUC patients, even after apparent clinical stabilization.
These results emphasize the need for clinicians to consider extended prophylactic measures and monitoring to mitigate thrombotic complications.
Reference:
Griffiths BJ, Desborough MJR, Duijvestein M, et al. Hypercoagulation after hospital discharge in acute severe ulcerative colitis: a prospective study. Inflamm Bowel Dis. 2025;23(10):1798-1807
