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Hospitalization of individuals with systemic lupus erythematosus: characteristics and predictors of outcome

Department of Rheumatology, Allergy and Immunology, Tan Tock Seng Hospital, Singapore, Department of Rheumatology, Southampton General Hospital, Southampton, UK, cedwards{at}soton.ac.uk

T Y Lian

Department of Rheumatology, Allergy and Immunology, Tan Tock Seng Hospital, Singapore

H Badsha

Department of Rheumatology, Allergy and Immunology, Tan Tock Seng Hospital, Singapore

C L Teh

Department of Rheumatology, Allergy and Immunology, Tan Tock Seng Hospital, Singapore

N Arden

Department of Rheumatology, Southampton General Hospital, Southampton, UK

H H Chng

Department of Rheumatology, Allergy and Immunology, Tan Tock Seng Hospital, Singapore

We performed a retrospective study of patients with systemic lupus erythematosus (SLE) admitted to hospital during a one-year period to describe characteristics associated with a poor outcome. There were 348 episodes of hospitalization of 223 individuals. The cause of admission was clinical flare of SLE (58%), infection (37%) and thromboembolic disease (8%). Readmission occurred in 35.8% and was associatedwith: active nephritis (HR 2.53, P < 0.01), flare of lupus (HR 2.0, P < 0.01) and more ACR criteria (HR 1.34 per extra criteria, P < 0.01). Individuals with multiple reasons for admission had a longer duration of stay [one four days (2,6), two five days (3,7) and three 9.5 days (6.5,14.5),P < 0.01]. There were 11 deaths (3.2% of admissions). The deaths were due to infection in nine cases (four with concurrent active SLE). In multivariate modelling, the main predictors of death were: previous multiple admissions (OR 12.4, P < 0.01), the presence of infection (OR 7.3, P < 0.01) and youngerage (OR 0.93 per increaseof one year, P 0.03). The presenceof active lupus nephritis and multisystem disease makes readmission more likely and individuals with multiple problems at the time of admission have longer hospital stays. Young patients with frequent readmissions and coexistent infections are most likely to die.

Key Words: hospitalization • outcome • systemic lupus erythematosus

Lupus, Vol. 12, No. 9, 672-676 (2003)
DOI: 10.1191/0961203303lu452oa


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