{"title":"Right heart failure outcomes in systemic lupus erythematosus: Cardiovascular insights from a nationwide inpatient study.","authors":"Nadhem Abdallah, Mohammed Samra","doi":"10.1177/09612033251366397","DOIUrl":null,"url":null,"abstract":"<p><p>BackgroundPatients with Systemic Lupus Erythematosus (SLE) face a higher risk of cardiovascular morbidity, but data on Right Heart Failure (RHF) in-hospital outcomes in the context of SLE remain limited. Using a nationwide hospitalization database, we assess the impact of SLE on cardiovascular outcomes in cases of RHF.MethodsRHF cases were queried from the 2016-2019 National Inpatient Sample, comparing outcomes between those with vs. without SLE. Primary outcome included all-cause mortality while secondary outcomes included vasopressor use, acute kidney injury (AKI), mechanical ventilation use, hospital length of stay (LOS), and total hospitalization charges (THC). Multivariable and linear regression models adjusted for confounders including patient demographics and comorbidity burden.ResultsOf 5,569 RHF hospitalizations, 2% (111) involved SLE. SLE was associated with higher mortality (adjusted OR [aOR] 3.8, 95% CI 1.19-12.29), AKI (aOR 2.61, 95% CI 1.05-6.52), vasopressor use (aOR 8.11, 95% CI 2.20-29.8). No differences were observed regarding odds of mechanical ventilation use (aOR 1.39, 95% CI 0.35-5.5), mean LOS (7.3 vs 6.5 days, <i>p</i> = .436) or THC ($258,475 vs $86,910, <i>p</i> = .301) between both groups.ConclusionAmong RHF hospitalizations SLE is associated with higher mortality and non-fatal adverse outcomes. Further studies are necessary to confirm these findings and to clarify mechanisms aimed at improving outcomes for SLE patients hospitalized with RHF.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":"34 11","pages":"1128-1134"},"PeriodicalIF":1.9000,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Lupus","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/09612033251366397","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/8/31 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"RHEUMATOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
BackgroundPatients with Systemic Lupus Erythematosus (SLE) face a higher risk of cardiovascular morbidity, but data on Right Heart Failure (RHF) in-hospital outcomes in the context of SLE remain limited. Using a nationwide hospitalization database, we assess the impact of SLE on cardiovascular outcomes in cases of RHF.MethodsRHF cases were queried from the 2016-2019 National Inpatient Sample, comparing outcomes between those with vs. without SLE. Primary outcome included all-cause mortality while secondary outcomes included vasopressor use, acute kidney injury (AKI), mechanical ventilation use, hospital length of stay (LOS), and total hospitalization charges (THC). Multivariable and linear regression models adjusted for confounders including patient demographics and comorbidity burden.ResultsOf 5,569 RHF hospitalizations, 2% (111) involved SLE. SLE was associated with higher mortality (adjusted OR [aOR] 3.8, 95% CI 1.19-12.29), AKI (aOR 2.61, 95% CI 1.05-6.52), vasopressor use (aOR 8.11, 95% CI 2.20-29.8). No differences were observed regarding odds of mechanical ventilation use (aOR 1.39, 95% CI 0.35-5.5), mean LOS (7.3 vs 6.5 days, p = .436) or THC ($258,475 vs $86,910, p = .301) between both groups.ConclusionAmong RHF hospitalizations SLE is associated with higher mortality and non-fatal adverse outcomes. Further studies are necessary to confirm these findings and to clarify mechanisms aimed at improving outcomes for SLE patients hospitalized with RHF.
系统性红斑狼疮(SLE)患者面临更高的心血管疾病风险,但SLE背景下右心衰(RHF)住院结果的数据仍然有限。使用全国住院数据库,我们评估SLE对RHF病例心血管结局的影响。方法从2016-2019年全国住院患者样本中查询srhf病例,比较SLE患者和非SLE患者的结局。主要结局包括全因死亡率,次要结局包括血管加压剂使用、急性肾损伤(AKI)、机械通气使用、住院时间(LOS)和总住院费用(THC)。多变量和线性回归模型调整混杂因素,包括患者人口统计学和合并症负担。结果5569例RHF住院患者中,2%(111例)涉及SLE。SLE与较高的死亡率(调整OR [aOR] 3.8, 95% CI 1.19-12.29)、AKI (aOR 2.61, 95% CI 1.05-6.52)、血管加压药使用(aOR 8.11, 95% CI 2.20-29.8)相关。两组在机械通气使用的几率(aOR 1.39, 95% CI 0.35-5.5)、平均LOS (7.3 vs 6.5天,p = .436)或THC (258,475 vs 86,910美元,p = .301)方面均无差异。结论:在RHF住院患者中,SLE与较高的死亡率和非致命性不良结局相关。需要进一步的研究来证实这些发现,并阐明旨在改善SLE合并RHF住院患者预后的机制。
期刊介绍:
The only fully peer reviewed international journal devoted exclusively to lupus (and related disease) research. Lupus includes the most promising new clinical and laboratory-based studies from leading specialists in all lupus-related disciplines. Invaluable reading, with extended coverage, lupus-related disciplines include: Rheumatology, Dermatology, Immunology, Obstetrics, Psychiatry and Cardiovascular Research…