Risk of venous thromboembolism among hospitalizations of adults with selected autoimmune diseases

Abstract

Previous research has suggested autoimmune diseases are risk factors for developing venous thromboembolism (VTE). We assessed whether having diagnoses of selected autoimmune diseases associated with anti-phospholipid antibodies—autoimmune hemolytic anemia (AIHA), immune thrombocytopenic purpura (ITP), rheumatoid arthritis (RA), and systemic lupus erythematosus (SLE)—were associated with having a VTE diagnosis among US adult hospitalizations. A cross-sectional study was conducted using the 2010 Nationwide Inpatient Sample of the Healthcare Cost and Utilization Project, Agency for Healthcare Research and Quality. VTE and autoimmune diseases were identified using International Classification of Diseases, Ninth Revision, Clinical Modification coded diagnoses information. The percentages of hospitalizations with a VTE diagnosis among all non-maternal adult hospitalizations without any of the four autoimmune diseases of interest and among those with AIHA, ITP, RA, and SLE diagnoses were 2.28, 4.46, 3.35, 2.65 and 2.77 %, respectively. The adjusted odds ratios (OR) for having a diagnosis of VTE among non-maternal adult hospitalizations with diagnoses of AIHA, ITP, RA, and SLE were 1.25 [95 % confidence interval (CI) 1.05–1.49], 1.20 (95 % CI 1.07–1.34), 1.17 (95 % CI 1.13–1.21), and 1.23 (95 % CI 1.15–1.32), respectively, when compared to those without the corresponding conditions. The adjusted OR for a diagnosis of VTE associated with a diagnosis of any of the four autoimmune diseases was 1.20 (95 % CI 1.16–1.24). The presence of a diagnosis of AIHA, ITP, RA, and SLE was associated with an increased likelihood of having a VTE diagnosis among the group of all non-maternal adult hospitalizations.

Perioperative medical management for patients with RA, SPA, and SLE undergoing total hip and total knee replacement: a narrative review

“…Patients with rheumatic diseases have more than double the risk of VTE compared to the general population, particularly when their disease is active [77][78][79][80][81]. This is not surprising given the association between inflammation and thrombosis [82].…”

Venous thromboembolism in systemic autoimmune diseases: A narrative review with emphasis on primary systemic vasculitides

“…The adjusted odds ratio for recorded diagnoses of VTE with hospitalization for the diagnosis of SLE was 1.23 (95% CI; 1.15-1.32) and for RA was 1.17 (95% CI; 1.13-1.21). 6 A summary of the above studies is shown in Table 1. The data consistently show an increased risk of VTE associated with autoimmune diseases, especially related to hospitalization.…”

Risk of venous thromboembolism occurrence among adults with selected autoimmune diseases: A study among a U.S. cohort of commercial insurance enrollees

“…Our aim was to add to the growing evidence of the association between autoimmune diseases and VTE and epidemiologic understanding in this regard [8–16]. We previously reported findings of a cross-sectional study using U.S. hospitalization data that indicated an increased likelihood of VTE diagnosis associated with a diagnosis of these autoimmune diseases [20]. The objectives of this study were to assess the risk of VTE among commercial health insurance enrollees who had a diagnosis of one or more of the same four autoimmune diseases using a longitudinal approach.…”