ArticleAnnals of the rheumatic diseases2020
Immunosuppression and the risk of readmission and mortality in patients with rheumatoid arthritis undergoing hip fracture, abdominopelvic and cardiac surgery.
Article in Annals of the rheumatic diseases, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
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Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it, 26 citations in OpenAlex.
- Perioperative biologic use and postoperative outcomes in patients with inflammatory arthritis: a systematic review.BMC rheumatology · 2026Pooled it
- Chronic Corticosteroid Use Is Associated with Higher Perioperative Morbidity After Elective Primary Total Hip Arthroplasty.Journal of clinical medicine · 2026Article
- Disease-modifying anti-rheumatic drugs are associated with increased readmission and reoperation rates following anterior cervical discectomy and fusion: a propensity-matched cohort study.Journal of spine surgery (Hong Kong) · 2026Article
- Systemic glucocorticoid exposure and postoperative infection risk in 143,782 appendectomy patients-a Danish longitudinal nationwide study.Langenbeck's archives of surgery · 2024Article
- The Treatment with Xinfeng Capsule Can Reduce the Risk of Readmission for Patients with Rheumatoid arthritis:A Cohort Study of Approximately 10000 Individuals.International journal of general medicine · 2024Article
- Mechanisms of Systemic Osteoporosis in Rheumatoid Arthritis.International journal of molecular sciences · 2022Review
- [Continue or interrupt? Antirheumatic treatment in elective surgery].Zeitschrift fur Rheumatologie · 2022Article
- Rheumatoid arthritis patients initiating rituximab with low number of previous bDMARDs failures may effectively reduce rituximab dose and experience fewer serious adverse events than patients on full dose: a 5-year cohort study.Arthritis research & therapy · 2022Observational
- [Perioperative management of treatment of patients with inflammatory rheumatic diseases : Updated recommendations of the German Society of Rheumatology].Zeitschrift fur Rheumatologie · 2022Article
- Long-term outcomes after coronary artery bypass surgery in patients with rheumatoid arthritis.Annals of medicine · 2021Article
- Inferior outcomes following cardiac surgery in patients with a functioning renal allograft.Interactive cardiovascular and thoracic surgery · 2021Observational
- Prognostic factors for the short-term mortality of patients with rheumatoid arthritis admitted to intensive care units.BMC rheumatology · 2020Article
- To immunosuppress: whom, when and how? That is the question with COVID-19.Annals of the rheumatic diseases · 2020Article
- Review
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Authors and funding
9 authors at 6 institutions in 1 country.
Funding
Abstract
objectivesThe impact of immunosuppression on postoperative outcomes has primarily been studied in patients undergoing joint replacement surgery. We aimed to evaluate the impact of biologics and glucocorticoids on outcomes after other major surgeries.
methodsThis retrospective cohort study used Medicare data 2006-2015 to identified adults with rheumatoid arthritis undergoing hip fracture repair, abdominopelvic surgery (cholecystectomy, hysterectomy, hernia, appendectomy, colectomy) or cardiac surgery (coronary artery bypass graft, mitral/aortic valve). Logistic regression with propensity-score-based inverse probability weighting compared 90-day mortality and 30-day readmission in patients receiving methotrexate (without a biologic or targeted synthetic disease-modifying antirheumatic drug (tsDMARD)), a tumour necrosis factor inhibitor (TNFi) or a non-TNFi biologic/tsDMARD <8 weeks before surgery. Similar analyses evaluated associations between glucocorticoids and outcomes.
resultsWe identified 10 777 eligible surgeries: 3585 hip fracture, 5025 abdominopelvic and 2167 cardiac surgeries. Compared with patients receiving methotrexate, there was no increase in the risk of 90-day mortality or 30-day readmission among patients receiving a TNFi (mortality adjusted OR (aOR) 0.83 (0.67 to 1.02), readmission aOR 0.86 (0.75 to 0.993)) or non-TNFi biologic/tsDMARD (mortality aOR 0.78 (0.49 to 1.22), readmission aOR 1.02 (0.78 to 1.33)). Analyses stratified by surgery category were similar. Risk of mortality and readmission was higher with 5-10 mg/day of glucocorticoids (mortality aOR 1.41 (1.08 to 1.82), readmission aOR 1.26 (1.05 to 1.52)) or >10 mg/day (mortality aOR 1.64 (1.02 to 2.64), readmission aOR 1.60 (1.15 to 2.24)) versus no glucocorticoids, although results varied when stratifying by surgery category.
conclusionsRecent biologic or tsDMARD use was not associated with a greater risk of mortality or readmission after hip fracture, abdominopelvic or cardiac surgery compared with methotrexate. Higher dose glucocorticoids were associated with greater risk.
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