Background/Purpose:

Systemic lupus erythematosus (SLE) is a chronic multiorgan disease that is associated with significant morbidity and mortality. Literature suggests improvement in the survival rates among SLE patients over the last decades. However, economic burden of SLE including health care and hospitalization is significantly high. The aim of this study is to evaluate the burden of hospitalization among SLE patients and assess the risk factors of hospitalization among SLE patients.

Methods:

All patients who are followed in rheumatology clinics (Tawam hospital) and fulfilled the American college of Rheumatology (ACR) SLE criteria were identified. Retrospective chart reviews for previous admissions in this hospital or any other Abu Dhabi Health Services Company (SEHA) hospitals were performed using electronic health records (available since 2009). Demographic data, reason for hospitalization, duration of hospitalization, ICU admission, and SLE features at time of admission were collected. Hospitalization rate was calculated as number of hospitalization divided by disease duration. Regression analysis for factors associated with hospitalization and with duration of hospitalization were performed.

Results:

Ninety one patients (88, 97%, females) were identified who fulfil ACR criteria with mean disease duration of 10.16 (SD ±5.5) years. Mean number of criteria of those patients are 5.6. Sixty six (72.5%) of these patients were admitted at least once to the hospital with a total of 222 admissions over the years and with the mean annual rate of hospitalization calculated at 27.5 %. Mean hospitalization duration was 5.9 days (SD±5.98). In 41 admissions, there were 2 reasons for admission In total, 32.4% admitted for SLE disease activity, 25.2% for infection, 30.2% for pregnancy and related conditions, 2.3% for medication side effects and 27.5% for other medical and surgical causes. SLE features during SLE activity admissions include lupus nephritis (50%), hematological manifestation (34.6%), arthritis (21.2%) and Neuropsychiatric lupus (19.2%). In 6% of hospital admissions, patients needed an intensive care (ICU) admission. In multivariable regression, the number of hospitalization was significantly associated with younger age at diagnosis (P=.02), and ever lupus nephritis (P=.003). In another multivariable analysis, increased duration of hospitalization was significantly associated with being admitted for SLE disease activity (p=.009), presence of DsDNA antibodies (P<.001), and admission to ICU (P<.001).

Conclusion:

Significant proportions of SLE patients were hospitalized during their disease course, with one third of hospitalizations due to active disease. Hospitalization of SLE patients carries a substantial economic burden on the healthcare system.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/cause-and-rate-of-hospitalization-of-lupus-patients/