The Influence of Parkinson's disease on the incidence of venous thromboembolic events and surgical outcomes of old patients: analysis based on current observational studies.

BACKGROUND AND AIMS: Recently, increasing studies have reported that Parkinson's disease (PD) may experience an increased incidence of venous thromboembolic events and complications for patients who undergo surgery. We aimed to explore the actual prevalence and risk factors of venous thromboembolism (VTE) for patients with PD as well as its influence on the operative outcomes.

METHODS: We searched PubMed, Embase, and Cochrane library up to 1 May 2025 for observational studies exploring the risk factors of venous thromboembolic events or comparing the frequency of venous thromboembolic events and complications in PD and non-PD patients. The primary outcomes were the risk factors for and incidence of venous thromboembolic events in patients with PD. The secondary outcome was comparing the complications or adverse events between PD and non-PD patients. Two reviewers screened the titles and abstracts of searched records for qualified reports according to the including and excluding criteria and extracted the data independently.

RESULTS: Finally, we totally identified 17 observational studies involving 760 380 patients for the present analysis. Our pooled results indicated that when compared to patients without PD, patients with PD had significantly higher incidence of venous thromboembolic events, including VTE (OR 1.35, 95% CI 1.11-1.65), deep vein thrombosis (DVT; OR 1.56, 95% CI 1.24-1.96) and pulmonary embolism (PE; OR 1.54, 95% CI 1.20-1.96), respectively. In addition, when comparing DVT (+) and DVT (-) in patients with PD, female patients with PD had a higher frequency of DVT (OR 2.45, 95% CI 1.47-4.06), patients with lower Barthel index [mean difference (MD) -11.5, 95% CI -20.85-2.15] and those with smaller abdominal circumference (MD -7.13 cm, 95% CI -9.99 to -4.26), respectively. When compared to PD patients without DVT, PD patients with DVT had significantly higher average real variability of systolic blood pressure (MD 3.2 mmHg, 95% CI 0.75-5.65), lower heart rate at admission (MD -3.32 bpm, 95% CI -6.58 to -0.06), higher D-dimer (MD 2.14 µg/mL, 95% CI 1.20-3.08), and longer duration of illness (MD 22.68 months, 95% CI 6.77-38.58), respectively. Our pooled analysis also indicated that PD increased complications and adverse events of patients receiving operation.

CONCLUSIONS: Patients with PD were more prone to venous thromboembolic events and had an increased incidence of intra- and post-operative complications. Though several risk factors of DVT were identified for Parkinson's patients, they need further demonstration with specific researches in the future. Greater vigilance should be exercised to make an informed decision regarding patient care and preferred healthcare setup for patients with PD.