Systemic Lupus Erythematosus
Short-Term Perioperative All-Cause Mortality and Cardiovascular Events in Women With Systemic Lupus Erythematosus
Article first published online: 30 MAY 2013
Copyright © 2013 by the American College of Rheumatology
Arthritis Care & Research
Volume 65, Issue 6, pages 986–991, June 2013
How to Cite
Yazdanyar, A., Wasko, M. C., Scalzi, L. V., Kraemer, K. L. and Ward, M. M. (2013), Short-Term Perioperative All-Cause Mortality and Cardiovascular Events in Women With Systemic Lupus Erythematosus. Arthritis Care Res, 65: 986–991. doi: 10.1002/acr.21915
- Issue published online: 30 MAY 2013
- Article first published online: 30 MAY 2013
- Accepted manuscript online: 4 DEC 2012 12:00AM EST
- Manuscript Accepted: 7 NOV 2012
- Manuscript Received: 14 MAR 2012
- Intramural Research Program, National Institute of Arthritis and Musculoskeletal and Skin Diseases, NIH
Persons with systemic lupus erythematosus (SLE) are at an increased risk of cardiovascular disease (CVD) events, but this excess CVD burden in the perioperative setting is yet to be determined. We aimed to determine the risk of perioperative short-term all-cause mortality and CVD events among women with SLE compared to those without SLE.
We conducted a cross-sectional analysis of pooled hospital discharge data of the Nationwide Inpatient Sample from 1998–2002. We abstracted diseases and procedures using International Classification of Diseases, Ninth Revision, Clinical Modification codes. The principal procedure was categorized into either a low, intermediate, or high risk level. Survey logistic regression adjusting for potential confounders provided estimates for stratum-specific odds of adverse events in women with SLE relative to those without SLE for each procedure risk level.
All-cause mortality was significantly greater among women with SLE having a low- (odds ratio [OR] 1.54, 95% confidence interval [95% CI] 1.00–2.37) or a high-risk principal procedure (OR 2.52, 95% CI 1.34–4.75) relative to women without SLE, but did not differ significantly among persons with intermediate-risk procedures. Women with SLE with a low-risk procedure were also more likely to experience a composite CVD event relative to women without SLE (OR 1.40, 95% CI 1.04–1.87).
Women with SLE are at an increased risk for short-term perioperative adverse events. These results highlight a need for greater scrutiny during perioperative evaluation and management of women with SLE.