Background/Purpose:

Infections are associated with significant morbidity and mortality in systemic lupus erythematosus (SLE). Clinical outcomes of SLE patients hospitalized is variable due to variable demographic distribution. Sepsis is defined as life-threatening organ dysfunction caused by a dysregulated host response to infection with significant increase in inpatient mortality. Data describing clinical outcomes and factors associated with poor outcomes of patients with sepsis with SLE is limited in current literature. Our objective is to evaluate factors affecting mortality in patients with sepsis and underlying SLE.

Methods:

We used the National Inpatient Sample (NIS) available through Healthcare Cost and Utilization Project (HCUP) to estimate the number of hospitalizations for sepsis among adult patients with SLE in the US from 2010-2014. ICD-9 CM codes were used to identify the population. Logistic regression analysis was used to identify independent associations of in-hospital mortality. We described the associations as patient factors and hospital factors.

Results:

We identified 35475 hospitalizations for sepsis with secondary diagnosis of SLE using NIS database from 2010-2014. There were 3557 inpatient deaths during these hospitalizations. Mean age of patients admitted with sepsis and SLE was 54.145 years. Analysis of the population with inpatient mortality, suggested increased odds of mortality with age, location & size of hospital and number of associated comorbidities. Odds of mortality were noted to decrease with female sex and insurance status, as reported in Table 1.

Conclusion:

This study suggests increased risk of inpatient mortality in males, with increasing age and increase in number of comorbidties. Previous studies have shown similar results. Urban and large hospitals were found to be associated with higher mortality. This may represent higher likelihood of patients with comorbidities like SLE being referred or transferred to larger urban hospitals. Serious infections continue to be an important source of mortality in SLE. And factors affecting the mortality can guide us to implement guidelines for prevention and management of infections including but not limited to vaccinations, especially in high risk subgroup including males, older population with SLE and patients with multiple comorbidities.

Table 1: Factors associated with inpatient mortality in patients with sepsis and underlying SLE

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/factors-affecting-inpatient-mortality-in-hospitalizations-for-sepsis-with-underlying-systemic-lupus-erythematosus-data-from-the-national-inpatient-sample-2010-2014/