TY - JOUR T1 - Cardiac Surgery in Systemic Lupus Erythematosus Patients: Clinical Characteristics and Outcomes JO - Reumatología Clínica (English Edition) T2 - AU - Tejeda-Maldonado,Javier AU - Quintanilla-González,Lauro AU - Galindo-Uribe,Jaime AU - Hinojosa-Azaola,Andrea SN - 21735743 M3 - 10.1016/j.reumae.2017.01.016 DO - 10.1016/j.reumae.2017.01.016 UR - https://reumatologiaclinica.org/en-cardiac-surgery-in-systemic-lupus-articulo-S217357431830090X AB - ObjectivesTo study the clinical characteristics and outcomes in systemic lupus erythematosus (SLE) patients who underwent cardiac surgery. MethodsRetrospective analysis of 30 SLE patients who underwent cardiac surgery at a single center. Demographics, comorbidities, clinical and serologic characteristics, cardiovascular risk scores and treatment were recorded. Type of surgery, postoperative complications, mortality and histology were analyzed. ResultsDisease duration at surgery was 2 years. Valve replacement was the procedure most frequently performed (53%), followed by pericardial window (37%). At least one postoperative complication developed in 63% (mainly infections). An aortic cross-clamp time ≥76min was associated with at least one postoperative complication (OR 6.4, 95% CI 1.1–35.4, P=.03). Early death occurred in 5 patients (17%) and late in 3 (10%); main causes were sepsis and heart failure. Disease activity was associated with pericardial window (OR 12.6, 95% CI 1.9–79, P=.007); lymphopenia≤1.200 (OR 10.1, 95% CI 1.05–97, P=.04); age≤30 years (OR 7.7, 95% CI 1.2–46.3, P=.02); and New York Heart Association class III (OR 7.0, 95% CI 1.1–42, P=.03). Postoperative infection was associated with length of hospital stay≥2 weeks (OR 54.9, 95% CI 5.0–602.1, P=.001); intensive care unit stay≥10 days (OR 20, 95% CI 1.6–171.7, P=.01); duration of mechanical ventilation ≥5 days (OR 16.9, 95% CI 1.5–171.7, P=.01); and pulmonary artery systolic pressure ≥50mmHg (OR 7.8, 95% CI 1.4–41.2, P=.01). ConclusionsCardiac surgery in SLE confers high morbidity and mortality. SLE-specific preoperative risk scores should be designed to identify prognostic factors. ER -