Background/Purpose: To determine if age, gender and racial discrepancies exist, and to determine the occurence of comorbidities among patients hospitalized with ischemic stroke with Systemic Lupus Erythematosus (SLE) in comparison to the general population.

Methods: We queried the Healthcare Cost and Utilization Project’s (HCUP) Nationwide Inpatient Sample (NIS) between 2004 and 2010 and separated the hospitalizations due to or with ischemic stroke using ICD 9 diagnostic codes previously established by HCUP. Among this population, we identified the patients with SLE and calculated the average age of patients with and without SLE at the time of hospitalization for ischemic stroke. In addition, we calculated the gender and racial distribution of occurrence of ischemic stroke among SLE patients compared to the general population using the above database. We also looked at the Charlson comorbidity index (CCI) among these populations. Using SAS 9.2, survey procedures were used to identify univariate predictors of ischemic stroke.

Results: A total of 790,912 (weighted N=3,900,707) patients who were hospitalized with ischemic stroke were available for analysis out of which 3428 (weighted N= 16,828) had SLE. On univariate analysis, the average age of ischemic stroke in the general population was 70.9+_0.02 years, whereas in the SLE population, the average age of ischemic stroke was 56.5+-0.30 years (p<0.0001). Among the general population, 53.61% of all ischemic stroke population was females; whereas among the SLE population, 85.98% of the population was females (p<0.0001). Of the general ischemic stroke population, 55.7% were white, 22.6% were black and 21.7% belonged to other races. Among the SLE population, 44.9% were white, 35.6% were black and 19.5% belonged to other races (p<0.0001). The average CCI for the SLE population was 3.48+-0.03 compared to 2.67+-0.00 among the general population (p<0.0001).

Conclusion: There are significant discrepancies in age, gender and racial distribution among patients with SLE hospitalized with ischemic stroke compared to the general population. Patients with SLE are at increased risk of stroke approximately 13 years before the general population. The preponderance of  SLE among female patients explains the increased incidence of ischemic stroke in females compared to the general population. Higher proportion of African American patients with SLE was hospitalized with ischemic stroke compared to the general population. The higher CCI is elucidated by the fact that SLE is a multisystemic disease, thus increasing the risk for comorbidities.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/age-gender-racial-and-comorbidity-differences-among-systemic-lupus-erythematosus-patients-hospitalized-with-ischemic-stroke-compared-to-the-general-population-a-nationwide-analysis/