Hospitalisation of individuals with systemic lupus erythematosus: an analysis of 84 patients

Montero, Sergio Rodríguez; Martínez, R; Marenco, JL

doi:10.1136/ard.2010.149021.4

Cited by 3 publications

(6 citation statements)

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“…Hence, patients with very active disease at the initial stage should be monitored closely. 38 Most of our patients had a disease duration from four to 572 weeks with a mean of 100.6 (SD 125.9); a mean of about two years from diagnosis and 61.7% reported previous flares suggesting active disease.…”

Section: Discussionmentioning

confidence: 82%

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Predictors and outcome of systemic lupus erythematosus (SLE) admission rates in a large teaching hospital in sub-Saharan Africa

Dzifa

Boima

Yorke

et al. 2017

Lupus

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Although it was previously believed that systemic lupus erythematosus was uncommon among Africans, it has become increasingly apparent that the incidence is higher, and socioeconomic challenges such as physician shortages, poor medical facility access, and poor health literacy may worsen prognosis. This retrospective study examines characteristics and outcomes of hospitalized systemic lupus erythematosus patients over a two-year period and serves as a baseline for comparison for future studies to examine the outcomes with the provision of more dedicated care. There were 51 patient admissions over a two-year period, with a mean duration from start of illness to admission of approximately two years. Duration of admission ranged from one to 140 days with a mean period of 26.12 days (SD ± 26.6). There were 22 deaths (43.1% of admissions), which were mainly due to infections and renal complications. Factors associated with risk of death in regression analysis were: infections, fever, disease flare, musculoskeletal involvement, amenorrhea, depression, a clinical finding of hepatomegaly, and chest infection. Understanding the effect and outcome of systemic lupus erythematosus across different countries can elucidate the role of genetic, environmental, and other causative factors in the progression of the disease.

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Section: Discussionmentioning

confidence: 82%

“…This is higher than most studies worldwide have reported. 37–39 This may be due to the inadequate health care services and lack of ICU services or the more complicated visceral organ involvement at the time of admission and high infection rate requiring a protracted hospital stay. 14…”

Section: Discussionmentioning

confidence: 99%

Predictors and outcome of systemic lupus erythematosus (SLE) admission rates in a large teaching hospital in sub-Saharan Africa

Dzifa

Boima

Yorke

et al. 2017

Lupus

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“…Studies done in many regions around the world reported that SLE flare with related complications and infections were the main reasons of hospitalizations. 14–20…”

Section: Discussionmentioning

confidence: 99%

“…Studies done in many regions around the world reported that SLE flare with related complications and infections were the main reasons of hospitalizations. [14][15][16][17][18][19][20] Our data showed that SLE flare contributes to higher number of hospital admissions which tops the list for allcause hospitalizations. Close to 50% of hospitalizations secondary to lupus flare in this present study is comparable to, but seen in higher frequency than data reported in different regions.…”

Section: Discussionmentioning

confidence: 99%

Early damage as measured by SLICC/ACR damage index is a predictor of hospitalization in systemic lupus erythematosus (SLE)

Raman

Yahya

et al. 2020

Lupus

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Background Hospital admissions and re-admissions in lupus patients are common occurrences that can lead to poor prognosis. Objectives We evaluated the leading causes of all-cause hospitalizations and their predictive factors in the Malaysian multi-ethnic SLE patients. Methods This is a retrospective study involving 300 SLE patients. Demographic data and details of hospitalizations from the year 1988 until 2019 were reviewed. Baseline and latest disease activity (SLEDAI-2 K) and SLICC/ACR damage index (SDI) scores were evaluated. To be eligible for this study, their SLE diagnosis and disease duration was at least one year; this is to ensure that the baseline disease damages were measured at least after 6 months of diagnosis and subsequent disease damage indexes were captured. Results Majority were of Chinese ethnicity 150 (50%). The cohort’s median age was 48 (18–82) years and median disease duration was 13 (1–52) years. 133 (44.3%) had SDI score of ≥1 at baseline (early damage). 69 (23%) had developed new organ damage during this study period. There were 222 (74%) patients ever hospitalized from this cohort. The main cause of hospitalization was lupus flare which included concurrent infection (n = 415 admissions, 46%), followed by elective admissions for procedures and others (n = 284 admissions, 31.5%). Admissions for treatment and disease related complications were 13.8%. 8.7% of admissions were due to infections alone. Median length of stay for SLE-related cause admissions was longer compared to non-SLE related causes. Jointly predictive factors for hospitalization were anti-phospholipid syndrome (OR 5.82), anti-Smith (OR 6.30), anti-SSA (OR 3.37), serositis (OR 14.56), neurological (OR 5.52) and high baseline SDI (OR 1.74), all p < 0.05. Conclusion Early damage in lupus as measured by SDI is a predictive value of hospitalization. Optimization in managing patients with pre-existing damage is crucial to reduce hospitalization risk and subsequent complications.

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“… 18 Internationally, 89% to 93% of patients with SLE meeting classification criteria are hospitalised during their disease course. 19 20 Given that the HMDC captures same-day drug infusions (although not the specific drug types) and procedures, at a minimum our cohort would represent patients with SLE with moderate-to-severe disease.…”

Section: Methodsmentioning

confidence: 99%

Hospitalisation for systemic lupus erythematosus associates with an increased risk of mortality in Australian patients from 1980 to 2014: a longitudinal, population-level, data linkage, cohort study

et al. 2021

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ObjectiveMortality rates for patients with SLE have not been reported in Australia. This study determined the association between a hospitalisation for SLE with mortality.MethodsPopulation-level cohort study of patients with SLE (n=2112; 25 710 person-years) and general population comparators (controls) (n=21, 120; 280 637 person-years) identified from hospital records contained within the WA Rheumatic Disease Epidemiological Registry from 1980 to 2013. SLE was identified by ICD-9-CM: 695.4, 710.0, ICD-10-AM: L93.0, M32.0. Controls were nearest matched (10:1) for age, sex, Aboriginality and temporality. Using longitudinal linked health data, we assessed the association between a hospitalisation for SLE mortality and mortality with univariate and multivariate Cox proportional hazards and competing risks regression models.ResultsAt timezero, patients with SLE were similar in age (43.96 years), with higher representation of females (85.1% vs 83.4%, p=0.038), Aboriginal Australians (7.8% vs 6.0%) and smokers (20.5% vs 13.2%). Before study entry, patients with SLE (mean lookback 9 years) had higher comorbidity accrual (Charlson Comorbidity Index ≥1 item (42.0% vs 20.5%)), especially cardiovascular disease (CVD) (44.7% vs 21.0%) and nephritis (16.4% vs 0.5%), all p<0.001. During follow-up (mean 12.5 years), 548 (26.0%) patients with SLE and 2450 (11.6%) comparators died. A hospitalisation for SLE increased the unadjusted (HR 2.42, 95% CI 2.20 to 2.65) and multivariate-adjusted risk of mortality (aHR 2.03, 95% CI 1.84 to 2.23), which reduced from 1980 to 1999 (aHR 1.42) to 2000–2014 (aHR 1.27). Females (aHR 2.11), Aboriginal Australians (aHR 3.32), socioeconomically disadvantaged (aHR 2.49), and those <40 years old (aHR 7.46) were most vulnerable. At death, patients with SLE had a higher burden of infection (aHR 4.38), CVD (aHR 2.09) and renal disease (aHR 3.43), all p<0.001.ConclusionsA hospitalisation for SLE associated with an increased risk of mortality over the 1980–2014 period compared with the general population. The risk was especially high in younger (<40 years old), socioeconomically disadvantaged and Aboriginal Australians.

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Hospitalisation of individuals with systemic lupus erythematosus: an analysis of 84 patients

Cited by 3 publications

References 0 publications

Predictors and outcome of systemic lupus erythematosus (SLE) admission rates in a large teaching hospital in sub-Saharan Africa

Predictors and outcome of systemic lupus erythematosus (SLE) admission rates in a large teaching hospital in sub-Saharan Africa

Early damage as measured by SLICC/ACR damage index is a predictor of hospitalization in systemic lupus erythematosus (SLE)

Hospitalisation for systemic lupus erythematosus associates with an increased risk of mortality in Australian patients from 1980 to 2014: a longitudinal, population-level, data linkage, cohort study

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