Hospitalization and outcome of systemic lupus erythematosus patients admitted to the Rheumatology ward of Kasr Al-Ainy University Hospital

Aim of the work

To determine the frequency, causes and disease features affecting outcome of hospitalized systemic lupus erythematosus (SLE) patients, length of hospital stay and the risk factors.

Patients and methods

132 SLE patients accounting for 167 hospitalizations were recruited from the Rheumatology outpatient clinic, Faculty of Medicine, Cairo University Hospitals during 2019. SLE disease activity index (SLEDAI) and systemic lupus international collaborating clinics damage index (SLICC-DI) were assessed. Data concerning admission was recorded.

Results

The mean age of the patients was 31.4 ± 10.7 years and disease duration of 91.5 ± 84.3 months. Their mean SLEDAI was 8.7 ± 7.2 and SLICC-DI was 0.87 ± 1.2. The frequency of hospitalization was 167/1456 follow up visits (11.5%): 127 single admissions and 40 recurrent admissions. 137 hospital admissions were females and 30 males (F:M 4.6:1).The most common causes of hospitalization were disease activity in 115/167 hospital admissions (68.9%), infection in 39/167 (23.4%), comorbidities in 33/167 (19.8%). Outcome of hospitalization was improvement in 154/167 (92.2%), morbidity in 7/167 (4.2%), and mortality in 5/167 (3%). Readmission occurred in 40/167 (24%). Higher SLEDAI and gastrointestinal involvement were risk factors for longer hospital stay (p = 0.001 and p = 0.003 respectively). Morbidity was related to higher SLEDAI and SLICC-DI while mortality was related to prolonged azathioprine intake and cardiovascular involvement.

Conclusion

Disease flare and infection were the most common causes of hospitalization among SLE patients. Higher disease activity and damage as well as cardiovascular involvement were the factors associated with worse outcome. Higher SLEDAI and gastrointestinal involvement were risk factors for longer hospital stay.