Risk factors for development of early infectious and noninfectious complications in systemic lupus erythematosus patients undergoing major surgery

Quintanilla-González, Lauro; Torres‐Villalobos, Gonzalo; Hinojosa‐Azaola, Andrea

doi:10.1177/0961203318799188

Cited by 13 publications

(9 citation statements)

References 28 publications

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“…Steroids, DMARDs and biologic agents have been used widely for the treatment of major organ involvement in SLE. 15 However, it has been reported that the use of these drugs may carry significant risks in major surgery, including THA. 16 In the present study, we did not find that the use of steroid or DMARDs could increase the risk of complications after THA, but the use of DMARDs, especially tacrolimus, was associated with a higher risk of complications in the univariate analysis.…”

Section: Discussionmentioning

confidence: 99%

Risk factors of perioperative complications and transfusion following total hip arthroplasty in systemic lupus erythematosus patients

Xiang

et al. 2019

Lupus

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Background In recent years, hip arthroplasty rates in systemic lupus erythematosus (SLE) patients have been increasing rapidly. Although patients with SLE generally show beneficial or desirable functional outcomes following total hip arthroplasty (THA), it has been reported that SLE patients after THA have increased risk of postoperative complications, especially during the period of hospitalization. Objectives In the present study, we aimed to identify possible factors associated with complications or transfusion of THA in SLE patients during hospitalization. Methods The present study was a retrospective study conducted in Peking Union Medical College Hospital. Data were collected from medical records of patients who underwent THA from January 2012 to June 2018. The primary outcome variable was perioperative complications, which was defined as having one or more of the following conditions: high fever, infection, impaired wound healing, venous thrombosis of the lower extremities, hematoma, arrhythmia, implant complications. The secondary outcome was perioperative transfusion. Results During January 2012 to June 2018, 100 patients had taken the surgery of THA. After multivariate analysis, independent risk factors for perioperative complications were: age ≥ 45 years ( p = 0.001), SLE with other connective tissue diseases ( p = 0.029), high temperature ( p = 0.030), positive anti-dsDNA antibody ( p = 0.043), and Systemic Lupus International Collaborative Clinics/American College of Rheumatology (SLICC/ACR) Damage Index ≥ 3 ( p = 0.008). Independent risk factors for perioperative transfusion were bilateral THA ( p = 0.029), low hemoglobin ( p = 0.021) and abnormal renal function ( p = 0.021). Conclusion For SLE patients following THA, age > 45 years, SLE with other connective tissue disease, high temperature, positive anti-dsDNA antibody and SLICC/ACR Damage Index ≥ 3 were the risk factors of complications during hospitalization and bilateral THA, low hemoglobin and abnormal renal function were the risk factors of transfusion.

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Section: Discussionmentioning

confidence: 99%

Risk factors of perioperative complications and transfusion following total hip arthroplasty in systemic lupus erythematosus patients

Xiang

et al. 2019

Lupus

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“…Due to concerns about perioperative acute coronary events and anticoagulant and antiplate therapy therapy, non-operative treatment is often preferred for patients with intestinal perforation complicated with septic shock with CHD. Although SLE patients present higher frequency of postoperative complications and mortality compared with non-SLE patients (28), there were more patients with intestinal perforation combined with septic shock combined with SLE in the operative group. The reason for above phenomenon may be that SLE is an autoimmune disease, and patients with SLE with septic shock have a low chance of self-healing, which is likely to lead to more positive treatment.…”

Section: Discussionmentioning

confidence: 82%

Effects of surgical treatment on 24465 patients with intestinal perforation complicated with septic shock in tertiary hospitals in China from 2017 to 2020: a systematic review

Wang

et al. 2021

Preprint

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Background Intestinal perforation often leads to abdominal infection and is one of the main causes of septic shock. Prompt surgical treatment is an important treatment for this disease. We designed this study to investigate the effects of surgical treatment on patients with intestinal perforation complicated with septic shock in China. Methods Tertiary hospitals were enrolled from the China National Critical Care Quality Control Center (China-NCCQC). The data were collected between January 1, 2017 and December 31, 2020. Intestinal perforation includes duodenal perforation, jejunal perforation, ileal perforation, colonic perforation, and rectal perforation. Sepsis 3.0 criteria were used for the diagnosis of septic shock. According to the above criteria, 26747 patients from 247915897 patients were selected. After excluding the missing data of gender, age and discharge mode, 24465 patients were remained. Results Patients with intestinal perforation complicated with septic shock in tertiary hospitals in China are more male and older patients. A significant proportion of patients were hospitalized for more than one month. The hospitalization cost per capita of these patients far exceeds the overall hospitalization cost per capita. In the operative group, the hospitalization days were longer. The operative group spent more. However, the incidence of complications was lower in the operative group. Patients with coronary heart disease (CHD) tended to be treated nonoperatively, and patients with systemic lupus erythematosus (SLE) tended to be treated surgically. 20% of the patients discharged against medical advice, 12% of the patients died. The operative group had a higher rate discharging with medical advice and a lower mortality rate. Conclusions For intestinal perforation complicated with septic shock in tertiary hospitals in China, patients who had surgery stayed longer and cost more. However, the incidence of complications was lower in the patients who had surgery. At the same time, the rate of discharging with medical advice was higher and the mortality rate was lower in the patients who had surgery.

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“…It has been reported that SLE patients have increased risk of postoperative complications after major surgery, those mostly results in an increased rate of bleeding and infections, especially during hospitalization. Such studies concern major orthopedic surgery, because these patients are often affected by arthritis and they often undergo hips or knee arthroplasty [26] , [27] . Post-operative course in maxillofacial surgery has not been investigated yet.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, postoperative course might trigger SLE in these kinds of patients because of the increasing secretion of inflammatory cytokines. [27] .…”

Section: Discussionmentioning

confidence: 99%

Frontal bone hyperostotic mass associated with fibrous dysplasia in a male patient with systemic lupus erythematosus (SLE)

Giampaoli

Chirumbolo

Ceglie

et al. 2021

International Journal of Surgery Case Reports

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We present a rare clinical report of a 45-year-old man affected by Systemic Lupus Erythematosus (SLE) with a unilateral mass of the left frontal bone, diagnosed as a possible recurrence of fibrous dysplasia. This patient was evaluated with computed tomography (CT scan) and was treated with resection of the mass and reconstruction with splitting a calvarian bone graft. The pathological evidence was suggestive for a bone cavernous haemangioma. No previously described cases of bone dysplasia associated with this systemic syndrome were reported so far. Patient's disease was under stringent control at the time of hospitalization, and the outcome has been successful, even though a mild increase of inflammatory indexes was reported after surgery. This laboratory evidence was transient and not related to further clinical complications.

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Risk factors for development of early infectious and noninfectious complications in systemic lupus erythematosus patients undergoing major surgery

Cited by 13 publications

References 28 publications

Risk factors of perioperative complications and transfusion following total hip arthroplasty in systemic lupus erythematosus patients

Risk factors of perioperative complications and transfusion following total hip arthroplasty in systemic lupus erythematosus patients

Effects of surgical treatment on 24465 patients with intestinal perforation complicated with septic shock in tertiary hospitals in China from 2017 to 2020: a systematic review

Frontal bone hyperostotic mass associated with fibrous dysplasia in a male patient with systemic lupus erythematosus (SLE)

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