title: Short-term perioperative all-cause mortality and cardiovascular events in women with systemic lupus erythematosus.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Section of Hospital Medicine, Department of Medicine, The Reading Hospital and Medical Center, West Reading, PA 19611, USA. a.yazzzd@gmail.com
authors.forename: Ali
authors.initials: A
authors.lastname: Yazdanyar
authors.forename: Mary Chester
authors.initials: MC
authors.lastname: Wasko
authors.forename: Lisabeth V
authors.initials: LV
authors.lastname: Scalzi
authors.forename: Kevin L
authors.initials: KL
authors.lastname: Kraemer
authors.forename: Michael M
authors.initials: MM
authors.lastname: Ward
mesh_terms: D000368:Aged; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D017558:Elective Surgical Procedures / Q000401:mortality*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008180:Lupus Erythematosus, Systemic / Q000150:complications*; D008875:Middle Aged; D010351:Patient Discharge / Q000706:statistics & numerical data; D059035:Perioperative Period; D012307:Risk Factors; D013997:Time Factors