Cardiac surgery in systemic lupus erythematosus patients: Clinical characteristics and outcomes
| Autor: | Javier Tejeda-Maldonado, Andrea Hinojosa-Azaola, Lauro Quintanilla-González, Jaime Galindo-Uribe |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent medicine.medical_treatment 030204 cardiovascular system & hematology Single Center Risk Assessment law.invention 03 medical and health sciences Young Adult 0302 clinical medicine Postoperative Complications Valve replacement law Risk Factors Internal medicine medicine Humans Lupus Erythematosus Systemic Cardiac Surgical Procedures Retrospective Studies 030203 arthritis & rheumatology business.industry Postoperative complication General Medicine Middle Aged medicine.disease Intensive care unit Pericardial window Cardiac surgery Blood pressure Treatment Outcome Heart failure Female business |
| Zdroj: | Reumatologia clinica. 14(5) |
| ISSN: | 2173-5743 |
| Popis: | Objectives To study the clinical characteristics and outcomes in systemic lupus erythematosus (SLE) patients who underwent cardiac surgery. Methods Retrospective 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. Results Disease 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 ≥76 min 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 ≥50 mmHg (OR 7.8, 95% CI 1.4–41.2, P = .01). Conclusions Cardiac surgery in SLE confers high morbidity and mortality. SLE-specific preoperative risk scores should be designed to identify prognostic factors. |
| Databáze: | OpenAIRE |
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