Cutaneous lupus erythematosus and the risk of deep venous thrombosis and pulmonary embolism: A Danish nationwide cohort study

Ahlehoff, Ole; Wu, Jashin J.; Raunsø, Jakob; Kristensen, Søren Lund; Khalid, Usman; Kofoed, Kristian; Gislason, Gunnar

doi:10.1177/0961203317716306

Cited by 29 publications

(20 citation statements)

References 13 publications

(12 reference statements)

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“…PE contributes to a major burden of disease and is a leading cause of disability-adjusted life years lost 12 . Known risk factors for PE include immobilization, trauma, surgery, cancer, obesity, hypercoagulable states, use of estrogen-based contraceptives and autoimmune diseases 2,[13][14][15] .…”

Section: Pulmonary Embolism and Obstructive Sleep Apneamentioning

confidence: 99%

Outcomes of patients hospitalized for acute pulmonary embolism by obstructive sleep apnea status

Joshi

Hajjali²,

Gokhale

et al. 2021

Pulm. circ.

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Pulmonary embolism (PE) is a major cause of cardiovascular morbidity and mortality. Obstructive sleep apnea (OSA) is increasingly recognized in the ageing population, especially with the rising obesity epidemic. The impact of OSA on inpatient mortality in PE is not well understood. We used the Nationwide Inpatient Sample databases from 2005 to 2016 to identify 755,532 acute PE patients (ageï³18 years). Among these 61,050 (8.1%) were OSA+. Temporal trends in length of stay (LOS), inpatient mortality and its association with OSA in PE patients were analyzed. The proportion of PE patients who were OSA+ increased from 2005 to 2016. OSA+ PE patients were younger and predominantly men. Despite a higher prevalence of traditional risk factors for inpatient mortality in OSA+ patients, OSA was associated with a lower risk of mortality in PE patients (OR, 95% CI; p: unadjusted 0.56, 0.53-0.58; p<0.0001 and adjusted 0.55, 0.52-0.58; p<0.0001). Overall mortality and LOS in PE patients decreased over time. Relative to OSA- patients, there was a slight increase in mortality among OSA+ PE patients over time, although the LOS remained unchanged between the 2 groups. In conclusion, OSA+ PE patients had a lower inpatient mortality compared to OSA- patients despite a higher prevalence of traditional mortality risk factors. Secondary pulmonary hypertension related to OSA with pre-conditioning of the right ventricle to elevated afterload may potentially explain the protective effect of OSA on mortality in PE. However, mechanistic studies need to further elucidate the links behind this association.

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Section: Pulmonary Embolism and Obstructive Sleep Apneamentioning

confidence: 99%

Outcomes of patients hospitalized for acute pulmonary embolism by obstructive sleep apnea status

Joshi

Hajjali²,

Gokhale

et al. 2021

Pulm. circ.

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“…Multiple cohort studies in patients with SLE have shown that they are at a higher risk of VTE, especially when associated with APLAs. Notably, Mok et al found a 11.9‐fold higher risk of VTE in patients with SLE than in the general population, and this association has been replicated in other studies . Patients with SLE have a higher risk for VTE in the first year after diagnosis .…”

Section: Introductionmentioning

confidence: 78%

Systemic Lupus Erythematosus Is Associated With a High Risk of Venous Thromboembolism in Hospitalized Patients Leading to Poor Outcomes and a Higher Cost: Results From Nationwide Inpatient Sample Database 2003‐2011

Kishore

Jatwani

Malhotra

et al. 2019

ACR Open Rheumatology

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ObjectiveVenous thromboembolism (VTE) is a major cause of mortality and morbidity in hospitalized patients, particularly those with autoimmune disorders. The Nationwide Inpatient Sample (NIS) database was analyzed to determine trends in the rate of hospitalization, mortality from VTE, epidemiology, and outcomes in hospitalized patients with systemic lupus erythematosus (SLE) to assess its impact.MethodsThe 2003‐2011 NIS database of the Healthcare Cost and Utilization Project was queried to identify all adults (age 18 years and older) hospitalized with SLE and VTE. Demographic characteristics and in‐hospital outcomes of this population were compared with those of patients with SLE without a VTE diagnosis. A multivariate logistic regression analysis was used to obtain the adjusted odds ratio (OR).ResultsThe total number of hospitalized patients with SLE was 299 595, of whom 9175 (3.06%) had VTE. After adjusting for potential confounders, compared with those without VTE, patients with SLE and VTE had significantly higher inpatient mortality (5% vs. 2.0%; OR 2.35 [95% confidence interval (CI) 2.10‐2.62]; P < 0.001), greater disability at discharge (34% vs. 26%; OR 1.53 [95% CI 1.46‐1.62]; P < 0.001), a longer length of stay (LOS) by 3.57 days, and higher cost of hospitalization by $25 400. In this database, patients with SLE and VTE were younger and of male sex. Also, African American race and a higher number of comorbidities were associated with an increased risk of VTE in patients with SLE.Conclusion VTE in hospitalized patients with SLE is associated with significantly higher inpatient mortality, greater disability at discharge, an increased LOS, and higher cost of hospitalization. This cross‐sectional study helps with quantifying the risk of VTE in hospitalized patients with SLE and provides information on the immense human and material cost this complication leads to. These data can be very useful in the development and implementation of appropriate prophylactic strategies in the high‐risk population with SLE.

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“…It has been shown that there is an increased risk for venous thromboembolism or pulmonary embolism in patients with pSS [99].…”

Section: Pulmonary Embolismmentioning

confidence: 99%

Lung complications of Sjogren syndrome

et al. 2020

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Primary Sjogren syndrome (pSS) is a systemic autoimmune disease characterised by lymphocytic infiltration of exocrine glands and by a number of systemic manifestations, including those regarding the lung. Pulmonary involvement in pSS includes interstitial lung disease (ILD) and airway disease, together with lymphoproliferative disorders.Patients with pSS-ILD report impaired health-related quality of life and a higher risk of death, suggesting the importance of early diagnosis and treatment of this type of pulmonary involvement. In contrast, airway disease usually has little effect on respiratory function and is rarely the cause of death in these patients.More rare disorders can be also identified, such as pleural effusion, cysts or bullae.Up to date, available data do not allow us to establish an evidence-based treatment strategy in pSS-ILD. No data are available regarding which patients should be treated, the timing to start therapy and better therapeutic options. The lack of knowledge about the natural history and prognosis of pSS-ILD is the main limitation to the development of clinical trials or shared recommendations on this topic. However, a recent trial showed the efficacy of the antifibrotic drug nintedanib in slowing progression of various ILDs, including those in pSS patients.

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Cutaneous lupus erythematosus and the risk of deep venous thrombosis and pulmonary embolism: A Danish nationwide cohort study

Cited by 29 publications

References 13 publications

Outcomes of patients hospitalized for acute pulmonary embolism by obstructive sleep apnea status

Outcomes of patients hospitalized for acute pulmonary embolism by obstructive sleep apnea status

Systemic Lupus Erythematosus Is Associated With a High Risk of Venous Thromboembolism in Hospitalized Patients Leading to Poor Outcomes and a Higher Cost: Results From Nationwide Inpatient Sample Database 2003‐2011

Lung complications of Sjogren syndrome

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