Post-Op VTE Risk in Rheumatic Disease Traces to Clotting Issues

March 26, 2015
Rita Baron-Faust

The increased risk for venous thromoboembolism after surgery among patients with rheumatic disease appears to trace to those conditions with a clotting component. However, joint surgery in general has a high risk of this complication.

Wong LE, Bass AR. Postoperative risk of venous thromboembolism in rheumatic disease patients.Curr Rheumatol Rep. 2015;17(2):11. doi: 10.1007/s11926-014-0488-6

2014 meta-analysis from Canada found that rheumatic disease patients in general are at three times greater risk for venous thromboembolism (VTE) than the general population. But a new meta-analysis suggests not all patients with rheumatic disease are at equal risk after undergoing surgery.

The analysis finds that rheumatoid arthritis (RA) patients undergoing elective arthroplasty are not at elevated VTE risk, but post-operative risk is increased for those with systemic lupus erythematosus (SLE) and antiphospholipid antibody syndrome (APS), which is linked to clotting problems.

Noting that VTE can be a complication of any surgery, but particularly orthopedic surgery, the study authors say their findings point up the importance of preoperative assessment for all rheumatic disease patients.

The authors note that previous studies find VTE risk to be 2 to 4 times higher in patients hospitalized for RA, SLE, ankylosing spondylitis, Sjögren’s, scleroderma, and dermatomyositis/polymyositis than among patients admitted for minor medical or surgical conditions. Studies have also found increased VTE risk among rheumatic patients undergoing hip or knee replacement.