Journal of Peking University(Health Sciences) >
Incidence and risk factors of deep vein thrombosis in patients with rheumatoid arthritis
Received date: 2022-06-27
Online published: 2024-04-10
Objective: To investigate the incidence and risk factors of deep vein thrombosis (DVT) in patients with rheumatoid arthritis (RA). Methods: The clinical data of RA patients who were hospi-talized in the Department of Rheumatology and Immunology of Aerospace Center Hospital from May 2015 to September 2021 was retrospectively analyzed, including demographic characteristics, concomitant diseases, laboratory examinations (blood routine, biochemistry, coagulation, inflammatory markers, rheumatoid factor, antiphospholipid antibodies and lupus anticoagulant, etc.) and treatment regimens. The patients were compared according to the presence or absence of DVT, and the t test, Mann-Whitney U test or Chi-square test were applied to screen for relevant factors for DVT, followed by Logistic regression analysis to determine risk factors for DVT in patients with RA. Results: The incidence of DVT in the RA patients was 9.6% (31/322); the median age of RA in DVT group was significantly older than that in non-DVT group [64 (54, 71) years vs. 50 (25, 75) years, P < 0.001]; the level of disease activity score using 28 joints (DAS28)-erythrocyte sedimentation rate (ESR) in DVT group was higher than that in non-DVT group [5.2 (4.5, 6.7) vs. 4.5(4.5, 5.0), P < 0.001]; the incidence of hypertension, chronic kidney disease, fracture or surgery history within 3 months, and varicose veins of the lower extremities in DVT group was higher than that in non-DVT group (P < 0.001). The levels of hemoglobin and albumin in DVT group were significantly lower than that in non-DVT group (P=0.009, P=0.004), while the D-dimer level and rheumatoid factor positive rate in DVT group were significantly higher than that in non-DVT group (P < 0.001). The use rate of glucocorticoid in DVT group was higher than that in non-DVT group (P=0.009). Logistic regression analysis showed that the age (OR=1.093, P < 0.001), chronic kidney disease (OR=7.955, P=0.005), fracture or surgery history within 3 months (OR=34.658, P=0.002), DAS28-ESR (OR=1.475, P=0.009), and the use of glucocorticoid (OR=5.916, P=0.003) were independent risk factors for DVT in RA patients. Conclusion: The incidence of DVT in hospitalized RA patients was significantly increased, in addition to traditional factors, such as age and chronic kidney disease, increased DAS28-ESR level and the use of glucocorticoid were also independent risk factors for DVT.
Key words: Rheumatoid arthritis; Venous thrombosis; Venous thromboembolism
Xiaofei TANG , Yonghong LI , Qiuling DING , Zhuo SUN , Yang ZHANG , Yumei WANG , Meiyi TIAN , Jian LIU . Incidence and risk factors of deep vein thrombosis in patients with rheumatoid arthritis[J]. Journal of Peking University(Health Sciences), 2024 , 56(2) : 279 -283 . DOI: 10.19723/j.issn.1671-167X.2024.02.012
| 1 | Cohen AT , Agnelli G , Anderson FA , et al. Venous thromboembolism (VTE) in Europe. The number of VTE events and associated morbidity and mortality[J]. Thromb Haemost, 2007, 98 (4): 756- 764. |
| 2 | 李湄蕾, 吴尚洁. 静脉血栓栓塞症复发风险评估研究进展[J]. 中华结核和呼吸杂志, 2021, 44 (8): 749- 754. |
| 3 | Goldhaber SZ . Risk factors for venous thromboembolism[J]. J Am Coll Cardiol, 2010, 56 (1): 1- 7. |
| 4 | Bacani AK , Gabriel SE , Crowson CS , et al. Noncardiac vascular disease in rheumatoid arthritis: Increase in venous thromboembolic events?[J]. Arthritis Rheum, 2012, 64 (1): 53- 61. |
| 5 | Matta F , Singala R , Yaekoub A , et al. Risk of venous thromboembolism with rheumatoid arthritis[J]. Thromb Haemost, 2009, 101 (1): 134- 138. |
| 6 | Kim SC , Schneeweiss S , Liu J , et al. The risk of venous thromboembolism in patients with rheumatoid arthritis[J]. Arthritis Care Res, 2013, 65 (10): 1600- 1607. |
| 7 | Ungprasert P , Srivali N , Spanuchart I , et al. Risk of venous thromboembolism in patients with rheumatoid arthritis: A systema-tic review and meta-analysis[J]. Clin Rheumatol, 2014, 33 (3): 297- 304. |
| 8 | 蒋鹏, 刘建龙, 贾伟, 等. 《欧洲血管外科学会(ESVS)2021年静脉血栓管理临床实践指南》临床热点解读[J]. 中国普通外科杂志, 2022, 31 (6): 717- 727. |
| 9 | Choi HK , Rho YH , Zhu YY , et al. The risk of pulmonary embo-lism and deep vein thrombosis in rheumatoid arthritis: A UK population-based outpatient cohort study[J]. Ann Rheum Dis, 2013, 72 (7): 1182- 1187. |
| 10 | Chung WS , Peng CL , Lin CL , et al. Rheumatoid arthritis inc-reases the risk of deep vein thrombosis and pulmonary thrombo-embolism: A nationwide cohort study[J]. Ann Rheum Dis, 2014, 73 (10): 1774- 1780. |
| 11 | Liang KP , Liang KV , Matteson EL , et al. Incidence of noncardiac vascular disease in rheumatoid arthritis and relationship to extra-articular disease manifestations[J]. Arthritis Rheum, 2006, 54 (2): 642- 648. |
| 12 | Conforti A , Berardicurti O , Pavlych V , et al. Incidence of venous thromboembolism in rheumatoid arthritis, results from a "real-life" cohort and an appraisal of available literature[J]. Medicine (Baltimore), 2021, 100 (33): e26953. |
| 13 | Ketfi C , Boutigny A , Mohamedi N , et al. Risk of venous thromboembolism in rheumatoid arthritis[J]. Joint Bone Spine, 2021, 88 (3): 105122. |
| 14 | Molander V , Bower H , Frisell T , et al. Risk of venous thromboembolism in rheumatoid arthritis, and its association with disease activity: A nationwide cohort study from Sweden[J]. Ann Rheum Dis, 2021, 80 (2): 169- 175. |
| 15 | Johannesdottir SA , Horváth-Puhó E , Dekkers OM , et al. Use of glucocorticoids and risk of venous thromboembolism: A nationwide population-based case-control study[J]. JAMA Intern Med, 2013, 173 (9): 743- 752. |
| 16 | Fragoulis G , Brock J , Basu N , et al. The role for JAK inhibitors in the treatment of immune-mediated rheumatic and related conditions[J]. J Allergy Clin Immunol, 2021, 148 (4): 941- 952. |
| 17 | Smolen JS , Genovese MC , Takeuchi T , et al. Safety profile of baricitinib in patients with active rheumatoid arthritis with over 2 years median time in treatment[J]. J Rheumatol, 2019, 46 (12): 7- 18. |
/
| 〈 |
|
〉 |