Background/Purpose : Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that is largely heterogeneous and can affect virtually any organ system. Each year about one-third of individuals with SLE are hospitalized, and it is one of the highest rated causes of readmission in the United States. We took an in-depth look at SLE patients admitted to Cedars-Sinai Medical Center (CSMC) who required early readmission to assess whether there were any opportunities that could have prevented readmission, as well as identify which patients are at highest risk for readmission.

Methods : We performed a retrospective cohort study to look at inpatient records of SLE patients at CSMC between January 2012 and July 2014. We identified patients with SLE that were readmitted within 30 days of discharge and whose primary hospitalization included an ICD-9 diagnosis of SLE (710.0). These readmitted patients were compared to patients with lupus who did not require early readmission. Finally, we used stepwise logistic regression to calculate which variables were associated with early readmission.

Results : The study group included 154 patients in the early readmission group, and 301 patients in the group that was not readmitted. The main causes for early readmission included cardiovascular, renal, and infectious complications. Age and gender did not play a significant role, however the readmission group had significantly more African American patients and more patients with publicly funded insurance. Immunosuppressive use, key laboratory values such as low hemoglobin, elevated creatinine, and lower albumin were also associated with early readmission.

Conclusion: We found higher rates of readmission among African Americans and patients with MediCal insurance. We also found that elevated creatinine, low hemoglobin, and low albumin levels were associated with readmission. Immunosuppressive use also correlated with readmission. Data collected in this study will allow for identification of patients at highest risk for early readmission, which will provide an opportunity to improve the discharge process and transitions in care in the lupus patient population.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/causes-and-predictors-of-early-readmission-in-systemic-lupus-erythematosus/