TY - JOUR
T1 - Risk of venous thromboembolism in knee, hip and hand osteoarthritis
T2 - A general population-based cohort study
AU - Zeng, Chao
AU - Bennell, Kim
AU - Yang, Zidan
AU - Nguyen, Uyen Sa D.T.
AU - Lu, Na
AU - Wei, Jie
AU - Lei, Guanghua
AU - Zhang, Yuqing
N1 - Funding Information:
Funding This work was supported by the National Natural Science Foundation of China (81772413, 81702207, 81702206, 81930071), the National Health and Medical Research Council Principal Research Fellowship, the National Key Research and Development Project (2018YFB1105705), and the Key Research and Development Program of Hunan Province (2018SK2070, 2018SK2071).
Publisher Copyright:
©
PY - 2020/12/1
Y1 - 2020/12/1
N2 - Objectives Osteoarthritis is a leading cause of immobility and joint replacement, two strong risk factors for venous thromboembolism (VTE). We aimed to examine the relation of knee, hip and hand osteoarthritis to the risk of VTE and investigate joint replacement as a potential mediator. Methods We conducted three cohort studies using data from The Health Improvement Network. Up to five individuals without osteoarthritis were matched to each case of incident knee (n=20 696), hip (n=10 411) or hand (n=6329) osteoarthritis by age, sex, entry time and body mass index. We examined the relation of osteoarthritis to VTE (pulmonary embolism and deep vein thrombosis) using a multivariable Cox proportional hazard model. Results VTE developed in 327 individuals with knee osteoarthritis and 951 individuals without osteoarthritis (2.7 vs 2.0 per 1000 person-years), with multivariable-Adjusted HR being 1.38 (95% CI 1.23 to 1.56). The indirect effect (HR) of knee osteoarthritis on VTE through knee replacement was 1.07 (95% CI 1.01 to 1.15), explaining 24.8% of its total effect on VTE. Risk of VTE was higher in hip osteoarthritis than non-osteoarthritis (3.3 vs 1.8 per 1000 person-years; multivariable-Adjusted HR=1.83, 95% CI 1.56 to 2.13). The indirect effect through hip replacement yielded an HR of 1.14 (95% CI 1.04 to 1.25), explaining 28.1% of the total effect. No statistically significant difference in VTE risk was observed between hand osteoarthritis and non-osteoarthritis (1.5 vs 1.6 per 1000 person-years; multivariable-Adjusted HR=0.88, 95% CI 0.67 to 1.16). Conclusion Our large population-based cohort study provides the first evidence that knee or hip osteoarthritis, but not hand osteoarthritis, was associated with an increased risk of VTE, and such an association was partially mediated through knee or hip replacement.
AB - Objectives Osteoarthritis is a leading cause of immobility and joint replacement, two strong risk factors for venous thromboembolism (VTE). We aimed to examine the relation of knee, hip and hand osteoarthritis to the risk of VTE and investigate joint replacement as a potential mediator. Methods We conducted three cohort studies using data from The Health Improvement Network. Up to five individuals without osteoarthritis were matched to each case of incident knee (n=20 696), hip (n=10 411) or hand (n=6329) osteoarthritis by age, sex, entry time and body mass index. We examined the relation of osteoarthritis to VTE (pulmonary embolism and deep vein thrombosis) using a multivariable Cox proportional hazard model. Results VTE developed in 327 individuals with knee osteoarthritis and 951 individuals without osteoarthritis (2.7 vs 2.0 per 1000 person-years), with multivariable-Adjusted HR being 1.38 (95% CI 1.23 to 1.56). The indirect effect (HR) of knee osteoarthritis on VTE through knee replacement was 1.07 (95% CI 1.01 to 1.15), explaining 24.8% of its total effect on VTE. Risk of VTE was higher in hip osteoarthritis than non-osteoarthritis (3.3 vs 1.8 per 1000 person-years; multivariable-Adjusted HR=1.83, 95% CI 1.56 to 2.13). The indirect effect through hip replacement yielded an HR of 1.14 (95% CI 1.04 to 1.25), explaining 28.1% of the total effect. No statistically significant difference in VTE risk was observed between hand osteoarthritis and non-osteoarthritis (1.5 vs 1.6 per 1000 person-years; multivariable-Adjusted HR=0.88, 95% CI 0.67 to 1.16). Conclusion Our large population-based cohort study provides the first evidence that knee or hip osteoarthritis, but not hand osteoarthritis, was associated with an increased risk of VTE, and such an association was partially mediated through knee or hip replacement.
KW - epidemiology
KW - knee
KW - osteoarthritis
UR - http://www.scopus.com/inward/record.url?scp=85091821266&partnerID=8YFLogxK
U2 - 10.1136/annrheumdis-2020-217782
DO - 10.1136/annrheumdis-2020-217782
M3 - Article
C2 - 32938637
AN - SCOPUS:85091821266
SN - 0003-4967
VL - 79
SP - 1616
EP - 1624
JO - Annals of the Rheumatic Diseases
JF - Annals of the Rheumatic Diseases
IS - 12
ER -