Hospitalization and mortality of patients with systemic lupus erythematosus

Objective. To describe hospitalization and mortality outcomes of patients with systemic lupus erythematosus (SLE) in the general population. Methods. Hospitalizations of patients with SLE (n = 76,961) were identified from the US Nationwide Inpatient Sample, spanning 5 years from 1998 to 2002. Correlates of mortality were analyzed using logistic regression, while those of hospitalization charges were studied using median regressions. Results. Overall, 11% of all hospitalizations were for SLE and/or lupus flare. There were 2454 (3.1%) hospitalizations that ended in death. Half of all deaths occurred within 7 days after admission. There were 3 peaks in mortality risk after admission, the first on Day 6, the second Day 33, the third Day 57. Patients in higher income strata and those with private insurance had better mortality outcomes than the rest. Hospitalization charges were expensive, at about US $10,000 per incident. Hospital charges were driven primarily by length of stay and number of medical procedures. Conclusion. Hospitalizations for SLE are expensive, and 1 in 30 hospitalizations culminates in death. There appears to be a trimodal pattern in the time risk of death following admission. Patients with higher socioeconomic status and those with private insurance were less likely to die in hospital.