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

2017 ◽  
Vol 44 (8) ◽  
pp. 1173-1178 ◽  
Author(s):  
Kaien Gu ◽  
Dafna D. Gladman ◽  
Jiandong Su ◽  
Murray B. Urowitz
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Length Of Stay ◽  
Lupus Erythematosus ◽  
Retrospective Chart Review ◽  
International Classification Of Diseases ◽  
Health Science ◽  
Science Center ◽  
Systemic Lupus ◽  
Short Period ◽  
Classification Of Diseases

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.

Epidemiology of cutaneous lupus erythematosus and the associated risk of systemic lupus erythematosus: a nationwide cohort study in Denmark

Lupus ◽  
2018 ◽  
Vol 27 (9) ◽  
pp. 1424-1430 ◽  
Author(s):  
M Prütz Petersen ◽  
S Möller ◽  
A Bygum ◽  
A Voss ◽  
M Bliddal
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Cohort Study ◽  
Lupus Erythematosus ◽  
Time Course ◽  
Cutaneous Lupus Erythematosus ◽  
International Classification Of Diseases ◽  
Systemic Lupus ◽  
Classification Of Diseases ◽  
National Patient ◽  
Cutaneous Lupus

Objectives The objectives of this paper are to describe the epidemiology of cutaneous lupus erythematosus (CLE) and its subtypes in Denmark, and to investigate the probability of receiving a subsequent diagnosis of systemic lupus erythematosus (SLE) and the related time course. Methods A nationwide registry-based cohort study was conducted in Denmark based on data from the Danish National Patient Registry from 1998 to 2013 using International Classification of Diseases, Revision 10. Results We identified 2380 patients with CLE. The annual incidence rate (IR) of CLE was 2.74/100,000 with a female:male ratio of 4:1. During 12,047 person-years of follow-up, 8% were diagnosed with SLE. The probability of receiving a subsequent diagnosis of SLE was 12.9% after 10 years taking death as a competing risk into consideration, and the probability was highest among women and patients diagnosed with subacute CLE. The median time until a diagnosis of SLE was 2.05 years. Conclusions This is the first nationwide study on CLE in Denmark. Although we found the annual IR of CLE and the risk of receiving an additional diagnosis of SLE to be lower than previously described, continued monitoring and thorough information for patients with CLE is important due to the inherent risk of SLE.

Hospitalization in patients with systemic lupus erythematosus at Tawam Hospital, United Arab Emirates (UAE): Rates, causes, and factors associated with length of stay

Lupus ◽  
2021 ◽  
pp. 096120332199008
Author(s):  
Reem Aldarmaki ◽  
Hiba I Al Khogali ◽  
Ali M Al Dhanhani
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Length Of Stay ◽  
Lupus Nephritis ◽  
United Arab Emirates ◽  
Lupus Erythematosus ◽  
Hospitalization Rate ◽  
Systemic Lupus ◽  
Factors Associated ◽  
Icu Admission ◽  
The Mean

Introduction Systemic lupus erythematosus (SLE) is a relapsing and remitting multiorgan disease associated with significant morbidity and mortality. The survival rate of patients with SLE has recently improved, which was associated with increased morbidity and hospitalization rates. Therefore, this study aimed to examine the rate and causes of hospitalization in patients with SLE and explore factors associated with increased length of stay (LOS). Methods Patients who visited rheumatology clinics (Tawam hospital, United Arab Emirates (UAE)) and fulfilled the American College of Rheumatology (ACR) SLE criteria were identified. Retrospective charts were reviewed to determine previous admissions. Demographic data, reason for hospitalization, duration of hospitalization, intensive care unit (ICU) admission, number of specialist consultations, medications used, and SLE characteristics at time of admission were collected. The hospitalization rate was calculated as the number of hospitalized patients divided by the total number of patients with the disease. We performed multivariable regression analysis for factors associated with increased LOS. Results A total of 91 patients with SLE (88 women and 3 men) met the inclusion criteria with a mean disease duration of 10.2 years (SD 5.5). A total of 222 admissions were identified, and 66 of 91 patients were admitted at least once. The mean crude hospitalization rate calculated was 29.8%. The primary reason for admission was pregnancy (29%), SLE activity (24%), and infection (20%). When combining primary and secondary reasons, the proportion of admissions due to SLE activity increased to 32%. The mean LOS was 5.9 (SD 6.0) days. About 7% of admitted patients required ICU admission. In multivariable analysis, patients with lupus nephritis, complications during hospitalization, and increased number of specialists consultations and who were admitted to ICU and started new medication were all associated with increased LOS. Conclusion A significant proportion of patients with SLE were hospitalized during their disease course. The hospitalization rate in this study appears to be higher than those reported elsewhere. Disease flare is the leading cause of admission in patients with SLE in this relatively young cohort. Lupus nephritis has been found to be significantly related to longer LOS. Measurements taken to reduce the incidence and severity of flares would likely decrease hospitalization rate and LOS in patients with SLE.

scholarly journals Lenalidomide for refractory cutaneous manifestations of pediatric systemic lupus erythematosus

Lupus ◽  
2016 ◽  
Vol 26 (6) ◽  
pp. 646-649 ◽  
Author(s):  
E Y Wu ◽  
L E Schanberg ◽  
E C Wershba ◽  
C E Rabinovich
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Cutaneous Lupus Erythematosus ◽  
Retrospective Chart Review ◽  
Rank Test ◽  
Systemic Lupus ◽  
Cutaneous Manifestations ◽  
Prednisone Dose ◽  
Pediatric Systemic Lupus Erythematosus ◽  
Cutaneous Lupus

Objective Cutaneous manifestations of pediatric systemic lupus erythematosus cause significant morbidity. Lenalidomide, a thalidomide analogue, has shown promise treating cutaneous lupus erythematosus in adults. Our objective was to evaluate lenalidomide’s efficacy and safety in treating refractory cutaneous manifestations of pediatric systemic lupus erythematosus. Methods We performed a retrospective chart review of 10 adolescents who received lenalidomide for recalcitrant cutaneous lupus erythematosus. Information was gathered at drug initiation and 6-month follow-up. The Wilcoxon matched-pairs signed-rank test was used to assess change in quantitative parameters of disease activity. Results Nine subjects were girls and six were African-American. Indications for lenalidomide treatment included alopecia, nasal and oral ulcers, extensive malar rash, discoid lesions, bullous lesions, panniculitis, cutaneous vasculitis, and Raynaud’s phenomenon with digital ulcerations. Within 6 months, all patients demonstrated complete or near resolution based on physician report. Prednisone dose decreased from a mean 23.5 mg (SD± 13.3) to 12.25 mg (SD± 9.2) ( P= 0.008). Sedimentation rate decreased from a mean 29 mm/hour (SD± 31.5) to 17 mm/hour (SD± 18.1) ( P= 0.004). Lenalidomide was well tolerated. Conclusion Lenalidomide is an effective and safe treatment for a spectrum of dermatological conditions in pediatric systemic lupus erythematosus. Its use may allow a reduction in prednisone dose and decreased disfigurement. Prospective study is needed to clarify lenalidomide’s role in treating cutaneous manifestations of systemic lupus erythematosus.

Hospitalization of patients with systemic lupus erythematosus is a major cause of direct and indirect healthcare costs

Lupus ◽  
2016 ◽  
Vol 26 (7) ◽  
pp. 756-761 ◽  
Author(s):  
A P Anandarajah ◽  
M Luc ◽  
C T Ritchlin
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Length Of Stay ◽  
Lupus Erythematosus ◽  
Annual Cost ◽  
Financial Analysis ◽  
Financial Burden ◽  
Indirect Costs ◽  
Memorial Hospital ◽  
Systemic Lupus ◽  
Direct And Indirect Costs

Objectives The objective of this study was to calculate the direct and indirect costs of admission for systemic lupus erythematosus (SLE) patients, identify the population at risk and investigate potential reasons for admission. Methods We conducted a financial analysis of all admissions for SLE to Strong Memorial Hospital between 1 July 2013 and 30 June 2015. Patient and financial records for admissions with a SLE diagnosis for the above period were retrieved. The total cost of admissions was used as a measure of direct costs and the length of stay used to assess indirect costs. Additionally, we analyzed the demographics of the hospitalized population. Results The average, annual cost of confirmed admissions to Strong Memorial Hospital for SLE was US$3.9–6.4 m. The mean annual cost per patient for hospitalization was US$51,808.41. The length of stay for all SLE patients was 1564–2507 days with an average of 8.5 days per admission. The majority of patients admitted were young women from the city of Rochester. Infections were the most common reason for admissions. Conclusion We demonstrated that admissions are a source of high direct and indirect costs to the hospital and a significant financial burden to the patient. Implementing measures to improve the quality of care for SLE patients will help decrease the morbidity and lower the economic costs to hospitals.

scholarly journals A CASE OF SYSTEMIC LUPUS ERYTHEMATOSUS THAT EXPERIENCED TWO IDIOPATHIC PERFORATIONS OF THE COLON OVER A SHORT PERIOD OF TIME

2011 ◽  
Vol 72 (9) ◽  
pp. 2318-2323 ◽  
Author(s):  
Masaki HATA ◽  
Koichiro NIWA ◽  
Shun ISHIYAMA ◽  
Makoto TAKAHASHI ◽  
Michitoshi GOTO ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Systemic Lupus ◽  
Short Period

Prevalence of systemic lupus erythematosus in Colombia: data from the national health registry 2012–2016

Lupus ◽  
2019 ◽  
Vol 28 (10) ◽  
pp. 1273-1278 ◽  
Author(s):  
D G Fernández-Ávila ◽  
S Bernal-Macías ◽  
D N Rincón-Riaño ◽  
J M Gutiérrez Dávila ◽  
D Rosselli
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Universal Coverage ◽  
Individual Case ◽  
Systemic Lupus ◽  
Classification Of Diseases ◽  
International Statistical Classification ◽  
Criteria For Diagnosis ◽  
Health Registry ◽  
Estimate Prevalence

Introduction Registries are essential to keep track of systemic lupus erythematosus (SLE) epidemiology and to provide better care to patients. The Colombian Ministry of Health has adopted a registry (SISPRO) to gather comprehensive information coming from the Colombian health system, which provides close to universal coverage (around 95%). The information collected from SISPRO is available for scientific analysis. Objectives We used data collected by SISPRO to estimate prevalence and specific characteristics of patients with SLE registered from January 2012 to December 2016. Methods This is a descriptive epidemiological study using the International Statistical Classification of Diseases and Related Health Problems as search terms related to SLE, based on SISPRO data. Criteria for diagnosis are not explicitly addressed in each individual case. Results National records report 41,804 patients with a diagnosis of SLE for an estimated prevalence of 91.9/100,000 subjects (based on a total population of 47,663,162), being more frequent in women (89% cases). When adjusted, female and male prevalences were 204.3 and 20.2 per 100,000 (ratio 10.1) with a 7.9:1 female:male ratio, and were highest in the 45–49-year age group. Conclusions This is the first study that describes demographic characteristics of SLE in Colombia, with useful information for decision makers. It also suggests a similar prevalence to other countries.

Aortitis in the setting of catastrophic antiphospholipid syndrome in a patient with systemic lupus erythematosus

Lupus ◽  
2020 ◽  
Vol 29 (9) ◽  
pp. 1126-1129
Author(s):  
Andrés González-García ◽  
Mónica López-Rodríguez ◽  
Sandra Redondo ◽  
José Luis Patier ◽  
Pilar Masso ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Antiphospholipid Syndrome ◽  
Lupus Erythematosus ◽  
Rare Condition ◽  
Intravenous Immunoglobulins ◽  
Systemic Lupus ◽  
Catastrophic Antiphospholipid Syndrome ◽  
Small Vessels ◽  
Short Period ◽  
Blue Toe Syndrome

Catastrophic antiphospholipid syndrome (CAPS) is a rare condition characterized by multiple thromboses affecting mainly small vessels in a short period of time in patients with antiphospholipid antibodies. A high suspicion index is mandatory in order to initiate rapidly aggressive immunomodulatory therapy to avoid a very poor prognosis. Systemic lupus erythematosus (SLE) is often associated with antiphospholipid syndrome, with a worse outcome when the catastrophic features occur. We report the case of a 64-year-old woman with a clinical debut of SLE who presented concomitantly with CAPS with several thrombosis affecting the kidney, spleen and bilateral limbs with blue toe syndrome in both legs. Furthermore, she presented with aortitis, with a malaise and myalgias and general syndrome (asthenia, hyporexia and mild weight loss). Fortunately, she had a good response to multi-target combination therapy (anticoagulants, corticosteroids, hydroxychloroquine, intravenous immunoglobulins, plasma exchange and rituximab). Here, we discuss the association between aortitis and CAPS secondary to SLE, and review the literature regarding similar conditions.

Infections Increase Risk of Arterial and Venous Thromboses in Danish Patients with Systemic Lupus Erythematosus: 5102 Patient-years of Followup

2014 ◽  
Vol 41 (9) ◽  
pp. 1817-1822 ◽  
Author(s):  
Renata Baronaite Hansen ◽  
Søren Jacobsen
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Herpes Zoster ◽  
Lupus Erythematosus ◽  
Respiratory Infections ◽  
Relative Rate ◽  
Retrospective Chart Review ◽  
Observation Time ◽  
Systemic Lupus ◽  
Increased Risk ◽  
Venous Thromboses

Objective.Infections and thromboses are known complications of systemic lupus erythematosus (SLE). We investigated if infectious episodes in patients with SLE were followed by an increased risk of thrombotic events.Methods.A cohort of 571 patients with prevalent or incident SLE was followed for a mean of 8.9 ± 7.6 years. All episodes of hospitalized infections or episodes of cutaneous herpes zoster as well as arterial and venous thrombotic events were identified by retrospective chart review and prospective updating of a clinical database. For time-dependent analyses adjusted for age, sex, and ever-presence of antiphospholipid antibodies, thrombotic events were classified as occurring during the time at risk of 1 year after an infection or during the remaining control observation time.Results.Of 271 infections identified, 104 were respiratory, 41 cutaneous herpes zoster, and 126 others. Of 159 thromboses identified, 98 were arterial. Incidence for arterial and venous thromboses within 1 year after infection was 2.18% and 2.56%, respectively, compared to patients who never had an infection (0.58 and 0.67). The adjusted 1-year risk of arterial and venous thrombosis after any infection was increased [relative rate (RR) 2.5, 95% CI 1.4–4.6, and RR 2.8, 95% CI 1.3–5.9, respectively]. Venous thromboses were in particular more prevalent after respiratory infections (RR 5.4, 95% CI 2.3–13).Conclusion.The temporal associations observed in this study indicate that infections could be risk factors for arterial or venous thromboses in patients with SLE, although causality was not addressed by this study.

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