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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 associated with: 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 younger age (OR 0.93 per increase of one year, P = 0.03). The presence of 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.

Original publication

DOI

10.1191/0961203303lu452oa

Type

Journal article

Journal

Lupus

Publication Date

01/2003

Volume

12

Pages

672 - 676

Addresses

Department of Rheumatology, Allergy and Immunology, Tan Tock Seng Hospital, Singapore. cedwards@soton.ac.uk

Keywords

Humans, Lupus Erythematosus, Systemic, Treatment Outcome, Length of Stay, Patient Readmission, Hospital Mortality, Survival Rate, Retrospective Studies, Predictive Value of Tests, Time Factors, Adolescent, Adult, Middle Aged, Hospitals, General, Hospitals, Public, Singapore, Female, Male