THROMBOTIC events remain a major driver of mortality and morbidity among patients with systemic lupus erythematosus (SLE).
Burden of Thrombotic Events in SLE
A nationwide analysis of more than 513,000 U.S. patients with systemic lupus erythematosus found that thromboembolic events are associated with substantial in-hospital risks and healthcare utilization. Using National Inpatient Sample data from 2003 to 2018, researchers assessed five major thrombotic complications including pulmonary embolism, deep vein thrombosis, cerebral venous sinus thrombosis, splanchnic thrombosis, and arterial thrombosis.
Deep vein thrombosis was the most frequent thrombotic event, affecting over 3% of hospitalized individuals with systemic lupus erythematosus, followed by pulmonary embolism in nearly 1.4%. Although cerebral venous sinus thrombosis was uncommon, arterial and atypical venous thromboses were still notable contributors to overall burden.
Demographic Disparities in Thrombosis
The study revealed significant variations in thrombotic prevalence across demographic groups. Males with systemic lupus erythematosus experienced higher rates of pulmonary embolism, deep vein thrombosis, splanchnic thrombosis, and arterial thrombosis than females. African American patients experienced disproportionately high rates of pulmonary embolism and deep vein thrombosis, despite making up less than one third of the full cohort.
Obesity was associated with higher prevalence across nearly all thrombotic event types except arterial thrombosis, where rates were lower. Smoking was also evaluated as a key clinical risk factor.
Clinical Consequences and Implications
Hospital outcomes were significantly worse among systemic lupus erythematosus patients who developed thrombotic events. Affected individuals experienced longer lengths of stay, higher inpatient care costs, and increased all-cause mortality across all event categories except cerebral venous sinus thrombosis.
These findings reinforce the need for timely recognition and targeted prevention strategies to mitigate thrombotic complications in systemic lupus erythematosus. The pronounced demographic disparities suggest that equity-focused interventions may help reduce avoidable morbidity and healthcare expenditure.
Reference: Singhal S et al. Prevalence, demographics, and mortality/morbidity of thrombotic events: A nationwide study of SLE patients in the United States. J Thromb Thrombolysis. 2025;doi:10.1007/s11239-025-03200-4.
