Prevalence of hospital readmissions and related factors in patients with autoimmune diseases

Abstract

Objective Autoimmune diseases generate an impact on the morbidity and mortality of patients and are a burden for the health system through hospital admissions and readmissions. The prevalence of readmission of patients with these diseases has not yet been described as a group, but rather as sub-phenotype. The objective of this study is to determine the prevalence of hospital readmissions in a Colombian population with autoimmunity and the factors related to readmission. Methods All patients with autoimmune diseases who were evaluated by the rheumatology service and hospitalized between August 2018 and December 2019 at the Fundación Hospital Infantil Universitario De San José de Bogotá were described. A bivariate analysis was done, and three multivariate logistic regression models were built with the dependent variable being readmission. Results Of the total 199 admissions, 131 patients were evaluated and 32% were readmitted. The most frequent sub-phenotype in both groups (readmission and no readmission) was SLE (51% and 59%). The most frequent cause of hospitalization and readmission was disease activity (68.7% and 64.3%). History of hypertension was associated with readmission (adjusted OR: 2.98–95% CI: 1.15–7.72). In a second model adjusted for confounding variables, no factor was associated. In a third model analyzing the history of kidney disease and previous use of immunosuppressants (adjusted for confounding variables), the previous use of immunosuppressants was related to readmission (OR: 2.78–95% CI 1.12–6.89). Conclusion Up to a third of patients with autoimmunity were readmitted and arterial hypertension was an associated factor. This suggested a greater systemic compromise and accumulated damage in patients who have these two conditions that may favor readmission. A history of immunosuppressant use may play a role in readmission, possibly by increasing the risk of developing infections.

Factors Predictive of In-Hospital Mortality in Patients with Systemic Lupus Erythematosus: A Single-Centre Retrospective Analysis

“…Prior hospitalization within 3 months was identified as an independent predictor of mortality in the current study. Consistent with previous findings, patients with SLE required frequent readmission, with disease activity as the primary reason for readmission ( 28 ). Previous studies have identified numerous risk factors associated with repeated remission, including disease flares, lupus nephritis, serositis, and thrombocytopenia.…”

“…In addition, patients who required readmission within a short period of time had more severe clinical manifestations than those who did not ( 6 , 29 ). Both disease activity and intensive immunosuppressive therapy make patients with SLE more susceptible to infection, contributing to increases in in-hospital mortality ( 28 ). Taken together, the available evidence highlights the importance of outpatient care, adherence to treatment, and patient education to reduce the risk of readmission and death.…”

A Nomogram Based on Comorbidities and Infection Location to Predict 30 Days Mortality of Immunocompromised Patients in ICU: A Retrospective Cohort Study

“… 4 Similarly, the global prevalence of autoimmune diseases is approximately 3%, up to 25% require hospitalization and, of these, above 30% call for ICU admission. 5 The same is true for malignant tumors, with one malignancy diagnosis in every six patients treated in European ICUs. 6 Immunocompromise is defined as having a weakened immune system with less resistance to infections and more fragility to some comorbidities.…”

The autoimmune tautology revisited

“…Since the last summary of evidence about the topic [ 2 ] several publications sustaining the theory have been published [ [1] , [2] , [3] , [4] , [5] , [6] , [7] , [8] , [9] , [10] , [11] , [12] , [13] , [14] , [15] , [16] , [17] , [18] , [19] , [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] , [39] , [40] , [41] , [42] , [43] , [44] , [45] , [46] , [47] , [48] , [49] , [50] , [51] , [52] , [53] , [54] , [55] , [56] , [57] , [58] , [59] , [60] , [61] , [62] , [63] , [64] , [65] , [66] , [67] , [68] , [69] , <...…”