Patients with systemic lupus erythematosus (SLE) face higher risks for surgical, clinical, obstetric, infectious, and other procedure- or care-related complications following abdominal, urologic, pelvic, or obstetric procedures than matched individuals without the condition, Medscape reported. Published online on October 9, 2026, in Rheumatology International, a retrospective cohort study using Brazilian health system data tracked 1708 patients with SLE alongside 8540 matched control individuals from 2008 to 2018.
Surgical Risks and Infection Rates in Brazilian Health Data
The analysis revealed sharp disparities in postoperative outcomes between patients with SLE and control groups over a 180-day window following surgery. Patients with SLE experienced surgical complications at a risk ratio of 2.20, while clinical complications showed a risk ratio of 3.30 compared to control individuals, with all figures reaching statistical significance at $P < .001$. Infectious complications climbed even higher, registering a risk ratio of 3.66. Other procedure- or care-related complications occurred at a notably elevated risk ratio of 11.33.
Obstetric procedures also carried heavier burdens for patients with SLE. Obstetric complications reached 7.7% in the SLE cohort compared with 4.1% in control individuals, yielding a risk ratio of 1.87. An algorithm-defined SLE reactivation occurred in 3.3% of the patients with lupus following their operations.
Hospital Stays, ICU Admissions, and Mortality Rates
The operational impact of these complications translated directly into longer and more intensive hospital resource utilization. Patients with SLE averaged a hospital stay of 4.92 days, compared to 3.08 days for control individuals. Intensive care unit admissions occurred among 8.7% of patients with SLE versus 3.4% of control individuals. In-hospital mortality reached 4.4% for the lupus cohort, compared with 0.8% for the control group.
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Cardiovascular risk factors among patients with SLE significantly amplified specific postoperative threats, showing adjusted odds ratios of 2.75 for clinical complications and 5.46 for other procedure- or care-related complications.
Study lacked direct measures of disease activity
Led by Francisco Eduardo Silva at the Universidade Federal do Rio de Janeiro, Campus Macaé, in Rio de Janeiro, Brazil, the research team noted distinct boundaries within their dataset. The study lacked direct measures of disease activity and specific treatment exposures, variables that could influence estimated surgical risks. Researchers defined SLE reactivation through a specific algorithm rather than interpreting the outcome as a clinically validated disease flare.
The study findings identify a higher-risk perioperative profile in this population, while the relative contributions of underlying disease activity and immunosuppressive treatment warrant further investigation,
the authors wrote.
Common Questions Regarding Lupus and Surgery
What types of procedures were included in the analysis?
Researchers examined abdominal, urologic, pelvic, and obstetric procedures performed between 2008 and 2018 using data from the Brazilian health system.
How were patients with SLE identified in the dataset?
The study identified patients with SLE using specific diagnosis codes, records of outpatient care for SLE, and documented immunosuppressive medication use within the 12 months prior to surgery.
What financial or institutional backing supported the research?
The study received financial support from the Coordination for the Improvement of Higher Education Personnel, Brazil, with authors reporting no competing interests.
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