Abstract
Background Systemic Lupus Erythematosus (SLE) patients experience frequent hospitalizations; lupus flares and infections have been shown to be the two most common causes. The aim of this study is to describe the main causes and predictors of first hospitalizations due to disease activity and infections in SLE patients.
Methods SLE patients from GLADEL, a multi-ethnic, multi-national Latin-American (LA) cohort were studied. The first hospitalization during these patients’ follow-up due to either infection and/or SLE disease activity was examined. Baseline sociodemographic, clinical, damage (SDI) and treatments were evaluated as possible predictors. First, descriptive analyses were performed. Predictors of infection or SLE disease activity associated hospitalization were identified using univariate and multivariate logistic.
Results A total of 1341 patients were included; 1201 (89.6%) were female. Their median interquartile range (IQR) age at diagnosis was 27 (20–37) years and their median IQR follow up time 27.5 (4.7–62.2) months; 456 (34.9%) patients were hospitalized; 344 (75.4%), 85 (18.6%) and 27 (5.9%) were hospitalized for disease activity, infections, or both, respectively, as depicted in graph 1. In the multivariable analysis, arthritis was associated with hospitalizations due to infection. Serositis, disease activity and damage were associated with hospitalizations due to disease activity. Older age, higher socioeconomic status and antimalarial use were found to be protective, as depicted in table 1.
Conclusions In this large LA lupus cohort, one third of the patients had at least one hospitalization; of them, three quarters were due to SLE disease activity. Our findings call attention for controlling disease activity and preventing damage using antimalarials early in the disease course disease to prevent the first hospitalization.
Reason for the first hospitalization
