The rate of and risk factors for frequent hospitalization in systemic lupus erythematosus: results from the Korean lupus network registry

Abstract

Objectives The survival rate of patients with systemic lupus erythematosus has improved in the last few decades, but the rate of hospitalization and health care costs for these patients remain higher than in the general population. Thus, we evaluated the rate of hospitalization and associated risk factors in an inception cohort of Korean patients with lupus. Methods Of the 507 patients with systemic lupus erythematosus enrolled in the KORean lupus NETwork, we investigated an inception cohort consisting of 196 patients with systemic lupus erythematosus presenting within 6 months of diagnosis based on the American College of Rheumatology classification criteria. We evaluated the causes of hospitalization, demographic characteristics, and laboratory and clinical data at the time of systemic lupus erythematosus diagnosis of hospitalized patients and during a follow-up period. We calculated the hospitalization rate as the number of total hospitalizations divided by the disease duration, and defined "frequent hospitalization" as hospitalization more than once per year. Results Of the 196 patients, 117 (59.6%) were admitted to hospital a total of 257 times during the 8-year follow-up period. Moreover, 22 (11.2%) patients were hospitalized frequently. The most common reasons for hospitalization included disease flares, infection, and pregnancy-related morbidity. In the univariate regression analysis, malar rash, arthritis, pericarditis, renal involvement, fever, systemic lupus erythematosus disease activity index > 12, hemoglobin level < 10 mg/dl, albumin level < 3.5 mg/dl, and anti-Sjögren's syndrome A positivity were associated with frequent hospitalization. Finally, multivariate analysis showed that arthritis, pericarditis, and anti-Sjögren's syndrome A antibody positivity at the time of diagnosis were risk factors for frequent hospitalization. Conclusions Our results showed that frequent hospitalization occurred in 11.2% of hospitalized patients and arthritis, pericarditis, and anti-Sjögren's syndrome A antibody positivity at the time of diagnosis were risk factors for frequent hospitalization.

Anti-nucleosome antibodies increase the risk of renal relapse in a prospective cohort of patients with clinically inactive systemic lupus erythematosus

“…In SLE patients, relapses have been associated with a decrease in health-related quality of life 25 , high levels of chronic damage 26 and an increase in mortality rates 27 . Furthermore, relapses constitute one of the main causes of hospitalization in SLE patients 28 . Therefore, further efforts must be made in order to detect the risk factors of future renal relapses.…”

Evaluation of an Automated Screening Assay, Compared to Indirect Immunofluorescence, an Extractable Nuclear Antigen Assay, and a Line Immunoassay in a Large Cohort of Asian Patients with Antinuclear Antibody-Associated Rheumatoid Diseases: A Multicenter Retrospective Study

“…Our study design has some limitations in that most of our study population was composed of females, especially the SS and MCTD groups. Among the hospitalized SLE patients, 165 out of 180 (91.8%) were female, based on the information in the Korean lupus network registry [ 33 ]. Although our data reflected a predominant portion of female patients, further studies involving male patients should be followed.…”

Very delayed lupus nephritis: a report of three cases and literature review

“…At SLE diagnosis, all three patients had arthritis and two had serositis and rash. Their serological profile shared a high ANA titre with diffuse pattern and anti-dsDNA and anti-Ro antibodies (the latter is known to be an independent risk factor for frequent hospitalisations 15 ). Despite the previously reported increased risk to develop DLN in patients with SS, 16 only one of our patients had this.…”