The frequency of and associations with hospitalization secondary to lupus flares from the 1000 Faces of Lupus Canadian cohort

Lee, J; Peschken, Christine A.; Muangchan, Chayawee; Silverman, Earl D.; Pineau, Christian; Cd, Smith; Arbillaga, Hector; Zummer, Michel; Clarke, Ann E.; Bernatsky, Sasha; Hudson, Marie; Hitchon, Carol; Fortin, Paul R.; Pope, Janet

doi:10.1177/0961203313505689

Cited by 26 publications

(30 citation statements)

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“…Some of the admissions may have been recurrent admissions of the same patient. This raises the concern that hospitalizations were not independent [30]. If patients were hospitalized multiple times within the eight year time period of this analysis, attributes including their race and gender would have been repeated in the database yet counted as individual patients.…”

Section: Discussionmentioning

confidence: 99%

Significant Reductions in Mortality in Hospitalized Patients with Systemic Lupus Erythematosus in Washington State from 2003 to 2011

et al. 2015

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BackgroundSystemic lupus erythematosus (SLE or lupus) is an autoimmune multisystem disease. While a complete understanding of lupus’ origins, mechanisms, and progression is not yet available, a number of studies have demonstrated correlations between disease prevalence and severity, gender, and race. There have been few population based studies in the United StatesObjectivesTo assess temporal changes in demographics and hospital mortality of patients with lupus in Washington State from 2003 to 2011Study DesignThis study used data from the Healthcare Cost and Utilization Project (HCUP), a patient information database, and data from the Washington State census to study a group of patients in the state. Lupus hospitalizations were defined as any hospitalization with an ICD-9-CM diagnosis code for systemic lupus erythematosus. Regression analysis was used to assess the effect of calendar time on demographics and hospital outcomes.ResultsThere were a total of 18,905 patients in this study with a diagnostic code for lupus. The mean age of the group was 51.5 years (95% CI: 50.6-52.3) in 2003 and 51.3 years (95% CI: 50.6-52.0) in 2011. The population was 88.6% female. Blacks were 2.8 times more likely to have a lupus hospitalization than whites when compared to the Washington population. While hospital mortality decreased during this eight year period (3.12% in 2003 to 1.28% in 2011, p=0.001) hospital length of stay remained statistically unchanged at an average of 4.9 days during that eight year period. We found a significant decrease in annual hospital mortality over the study period [odds ratio(OR): 0.92 per year, 95% CI 0.88-0.96, P<0.001]. Hospital mortality was higher in males (2.6% male death to 1.8% female death)ConclusionsIn this large group of hospitalized lupus patients in Washington, hospital length of stay remained relatively stable over time but hospital mortality decreased by over 50% over the eight year study period.

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Section: Discussionmentioning

confidence: 99%

Significant Reductions in Mortality in Hospitalized Patients with Systemic Lupus Erythematosus in Washington State from 2003 to 2011

et al. 2015

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“…This aligns with previous reports naming lupus nephritis as one of the most common reasons for hospitalization in SLE flare, and neurological manifestations standing as rare, although one study found haematologic, serositis and musculoskeletal involvement as the most common reason for hospitalization in these patients. 5,8…”

Section: Discussionmentioning

confidence: 99%

“…3–7 Moreover, some variables have been linked with admission, namely shorter disease duration, elevated body mass index, higher number of American College of Rheumatology (ACR) criteria fulfilled, average daily dose of prednisolone above 10 mg, neurological symptoms and the presence of co-morbidities such as cardiovascular disease. 3,5,8,9 In addition to frequent hospitalizations, readmission rates are also high in SLE patients, with factors such as clinical flare, lupus nephritis, serositis, thrombocytopenia and higher number of ACR criteria fulfilled being associated with repeated admissions. 2,10…”

Section: Introductionmentioning

confidence: 99%

“…Notwithstanding the number of publications on this topic, they presented some limitations, such as the data either deriving from national registries lacking specific clinical information about each patient 8,9,11–13 or being obtained from the medical record of each patient in unicentric studies, gaining clinical information, but limiting the sample size and the follow-up period of the study. 1,2,5,7,8,14…”

Section: Introductionmentioning

confidence: 99%

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Causes and factors related to hospitalizations in patients with systemic lupus erythematosus: analysis of a 20-year period (1995–2015) from a single referral centre in Catalonia

Rosa

Ortega

Teixeira

et al. 2019

Lupus

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Introduction Although extensively characterized in the outpatient setting, systemic lupus erythematosus (SLE) in the hospitalization wards is still scarcely portrayed, particularly in the perspective of its evolution over the years. Methods Retrospective analysis of SLE patients hospitalized in the Department of Autoimmune Diseases of a university hospital during a 20-year period (1995–2015), describing hospitalization characteristics, causes and predictors of outcome. Results A total of 814 hospitalizations concerning 339 patients were analysed. The main causes of admission were flare (40.2%), infection (19.2%), diagnostic procedures (18.8%) and thrombotic events (5.4%). Therapy with cyclophosphamide (odds ratio (OR) 1.908, p = 0.047) was associated with admission due to infection, while antimalarials displayed a protective effect (OR 0.649, p = 0.024). Nearly 3.9% of patients required admission to an intensive care unit, with associated antiphospholipid syndrome (OR 7.385, p = 0.04) standing as a predicting factor for this outcome. Readmission at 30 days occurred in 5.8% of patients, with thrombocytopenia (OR 6.007, p = 0.002) and renal involvement (OR 3.362, p = 0.032) featuring as predicting factors. Eight patients died, with antiphospholipid syndrome (OR 26.814, p = 0.02) and thrombocytopenia (OR 31.523, p = 0.01) being associated with mortality. There was no significant variation in patients' demographics or admission causes across the 20-year period, except for a decrease in admissions due to thrombotic and musculoskeletal causes. Recently, an increase in the use of mycophenolate mofetil and lower doses of glucocorticoids were noted. Conclusion While demographics of SLE hospitalizations have not markedly changed over the past 20 years, changes in therapy patterns were observed. Thrombocytopenia, antiphospholipid syndrome and renal involvement featured as predictors of poor outcome.

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“…Few studies on hospitalisation of patients with SLE have been reported earlier. [1][2][3][4][5][6] These studies have involved North Americans, 2 3 Asians 1 but not North Africans. We found that SLE was responsible for 5.95% of all admissions in our department.…”

Section: Discussionmentioning

confidence: 99%

Causes and outcome of hospitalisations in Tunisian patients with systemic lupus erythematosus

et al. 2014

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ObjectiveTo describe the most common reasons of admission of Tunisian patients with systemic lupus erythematosus (SLE) and the outcomes of these hospitalisations.MethodThe charts of patients with SLE who were hospitalised at our Department of Internal Medicine during a 2-year period from January 2011 to December 2012 were retrospectively reviewed, and the demographic characteristics, clinical and laboratory features, as well as all comorbidities, were collected.ResultsThere were 128 episodes of hospitalisation of 87 patients with SLE. 25 patients (28.7%) were admitted twice or more. The median length of stay for all admissions was 11 days (2–76). The total number of days of hospitalisation was 1896 days, which represent 10.7% of the total number of days of hospitalisation in our department. The most common overall reason for hospitalisation was active SLE (55 events, 43%). In 29 patients, SLE was newly diagnosed during hospitalisation. Other causes of hospitalisation included assessment of the disease, infections (9.4%) and associated autoimmune disease (6.25%). Adverse drug reaction (3.1%) and thromboembolic events (1.25%) were uncommon causes of hospitalisations. There was a significant difference in length of stay between patients admitted with SLE flare and those admitted for non-SLE flare reasons (p<0.01). Four hospitalisations (3%) resulted in death. The principal cause of death was active SLE.ConclusionsHospitalisation of patients with SLE is common in our department. Our study of this North African SLE population confirms the findings of previous studies suggesting that active SLE and infection remain the most common causes of hospitalisation of patients with SLE.

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The frequency of and associations with hospitalization secondary to lupus flares from the 1000 Faces of Lupus Canadian cohort

Abstract: The mean annual rate of hospitalization attributed to lupus was lower than expected. Hematologic, serositis, MSK and renal were the most common reasons. In a regression model elevated BMI, more ACR criteria and psychosis were associated with hospitalization.

Cited by 26 publications

References 32 publications

Significant Reductions in Mortality in Hospitalized Patients with Systemic Lupus Erythematosus in Washington State from 2003 to 2011

Significant Reductions in Mortality in Hospitalized Patients with Systemic Lupus Erythematosus in Washington State from 2003 to 2011

Causes and factors related to hospitalizations in patients with systemic lupus erythematosus: analysis of a 20-year period (1995–2015) from a single referral centre in Catalonia

Causes and outcome of hospitalisations in Tunisian patients with systemic lupus erythematosus

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