Background/Purpose: Dermatomyositis (DM) is a rare autoimmune disease associated with higher rates of hospitalization, longer lengths of stay, higher mean hospitalization costs, and increased inpatient mortality. However, current studies investigating DM inpatient stays have used larger population-based datasets and have not assessed the underlying, patient-level factors that may contribute to worse inpatient outcomes – a gap that we aim to address in this study.

Methods: We conducted a retrospective chart review of 148 DM patients admitted to Johns Hopkins Hospital between October 2013 and February 2024. Demographic and clinical characteristics were analyzed using chi-squared tests, t-tests, and adjusted logistic regression modeling to identify factors associated with mortality.

Results: Out of 148 patients, 16 (10.8%) died during hospitalization. Compared to survivors, patients who died had a shorter duration of active DM before admission (4.08 vs. 7.57 years, p=0.023) and were more likely to have primary admission diagnoses involving respiratory complications (43.8% vs. 15.9%, p=0.019) or infections (18.8 vs 5.3%, p=0.135). Patients with pre-existing interstitial lung disease (ILD) were more likely to die (p< .01, OR 8.50, 95% CI 1.99-36.33) than patients without ILD. Infection (p< .01), bacteremia (p< .01), deep vein thrombosis/pulmonary embolism (DVT/PE) (p< .01), and respiratory failure (p< .001) were significantly associated with in-hospital mortality. Notably, every patient who died experienced respiratory failure during admission. Neither cancer nor the type of dermatomyositis (classic vs. clinically amyopathic) impacted mortality.

Conclusion: Pre-existing ILD and in-hospital adverse events, particularly respiratory failure, are significant predictors of inpatient mortality in DM patients. Clinicians should prioritize early identification and management of these risk factors to improve hospital outcomes in this population.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/clinical-characteristics-associated-with-inpatient-mortality-in-dermatomyositis-patients-a-single-center-retrospective-cohort-study/