Background Little was know about the outcomes after surgery in pediatric patients with systemic lupus erythematosus (SLE).

Objectives Our purpose is to investigate the postoperative adverse events among surgical pediatric patients with preoperative SLE in a nationwide population-based study.

Methods We used Taiwan's National Health Insurance Research Database to identify pediatric inpatients with SLE and 258294 controls receiving major surgery. Sociodemographic characteristics, preoperative comorbidities, postoperative 30-day in-hospital major complications and mortality were analysed among surgical patients with and without SLE.

Results Pediatric patients with SLE had a higher prevalence of preoperative coexisting medical conditions and postoperative major complications. The OR of 30-day postoperative mortality for surgical patients with SLE was 8.55 (95% CI 2.65–27.6) after adjustment. Among pediatric patients, SLE was associated with postoperative pneumonia (OR 8.79, 95% CI 5.54–13.9), acute renal failure (OR 30.6, 95% CI 14.8–63.2), admission to intensive care unit (OR 2.16, 95% CI 1.55–3.00), prolonged length of stay (OR 2.45, 95% CI 1.78–3.38) and increased medical expenditure (OR 2.64, 95% CI 1.92–3.63).

Conclusions Among pediatric population, SLE significantly increased the risks of surgical complications and mortality after major surgery. Our findings demonstrated the need for integrated care and revised protocols for perioperative management to improve outcomes for pediatric patients with SLE.

Disclosure of Interest None declared