Hospitalizations in Patients with Systemic Lupus Erythematosus in an Academic Health Science Center

Objective. Hospitalization occurs in about 10% of patients with systemic lupus erythematosus (SLE) each year and accounts for most of the direct cost of SLE patient care. We aimed to determine the frequency of admissions of patients with SLE and describe their causes and outcomes. Methods. We identified all hospitalizations at University Health Network in the periods 2011-2012 and 2013- 2015 with an International Classification of Diseases, 10th ed. code of M32 (SLE). A retrospective chart review of these patients categorized them based on SLE care provider and cause of admission. Frequency of emergency room visits and duration of hospitalization were ascertained. Poisson and linear regressions were performed to determine factors associated with frequency and duration of hospitalizations. Results. There were 247 unique patients with SLE who were hospitalized a total of 491 times: 87.4% were women, average age of 43.9 +/- 17.9 years, and disease duration 13.7 +/- 12.3 years. Incidental causes were most common (35.6%); 21.4% and 22.4% of admissions were because of active SLE and infection, respectively. The patients with SLE averaged 1.6 hospitalizations lasting 8.5 days. Thirteen percent of hospitalizations resulted in intensive care unit admission, and 2.8% of hospitalizations resulted in death. Patient employment was associated with fewer hospitalizations during 2011-2015. Antimalarial use was associated with fewer hospitalizations as well as shorter length of stay during 2011-2012. The presence of damage correlated with increased hospitalizations. Higher educational level and antimalarial use correlated with shorter length of stay. Conclusion. Patients with SLE are frequently hospitalized, often because of active SLE or infection, and re- hospitalized within a short period of time. (First Release June 15 2017; J Rheumatol 2017; 44: 1173- 8; doi: 10.3899/ jrheum. 170072)