Early damage as measured by SLICC/ACR damage index is a predictor of hospitalization in systemic lupus erythematosus (SLE)

Raman, Leela and Yahya, Fariz and Ng, Choung Min and Sockalingam, Sargunan and Ramasamy, Kuganathan and Ratnam, Ravinash and Raja, Jasmin (2020) Early damage as measured by SLICC/ACR damage index is a predictor of hospitalization in systemic lupus erythematosus (SLE). Lupus, 29 (14). pp. 1885-1891. ISSN 0961-2033, DOI https://doi.org/10.1177/0961203320962848.

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Abstract

Background Hospital admissions and re-admissions in lupus patients are common occurrences that can lead to poor prognosis. Objectives We evaluated the leading causes of all-cause hospitalizations and their predictive factors in the Malaysian multi-ethnic SLE patients. Methods This is a retrospective study involving 300 SLE patients. Demographic data and details of hospitalizations from the year 1988 until 2019 were reviewed. Baseline and latest disease activity (SLEDAI-2 K) and SLICC/ACR damage index (SDI) scores were evaluated. To be eligible for this study, their SLE diagnosis and disease duration was at least one year; this is to ensure that the baseline disease damages were measured at least after 6 months of diagnosis and subsequent disease damage indexes were captured. Results Majority were of Chinese ethnicity 150 (50%). The cohort's median age was 48 (18-82) years and median disease duration was 13 (1-52) years. 133 (44.3%) had SDI score of >= 1 at baseline (early damage). 69 (23%) had developed new organ damage during this study period. There were 222 (74%) patients ever hospitalized from this cohort. The main cause of hospitalization was lupus flare which included concurrent infection (n = 415 admissions, 46%), followed by elective admissions for procedures and others (n = 284 admissions, 31.5%). Admissions for treatment and disease related complications were 13.8%. 8.7% of admissions were due to infections alone. Median length of stay for SLE-related cause admissions was longer compared to non-SLE related causes. Jointly predictive factors for hospitalization were anti-phospholipid syndrome (OR 5.82), anti-Smith (OR 6.30), anti-SSA (OR 3.37), serositis (OR 14.56), neurological (OR 5.52) and high baseline SDI (OR 1.74), all p < 0.05. Conclusion Early damage in lupus as measured by SDI is a predictive value of hospitalization. Optimization in managing patients with pre-existing damage is crucial to reduce hospitalization risk and subsequent complications.

Item Type: Article
Funders: UNSPECIFIED
Uncontrolled Keywords: Systemic lupus erythematosus; organ damage; SDI; hospitalization
Subjects: R Medicine
R Medicine > R Medicine (General) > Medical technology
Divisions: Faculty of Medicine
Faculty of Medicine > Medicine Department
Depositing User: Ms Zaharah Ramly
Date Deposited: 29 Nov 2023 07:38
Last Modified: 29 Nov 2023 07:38
URI: http://eprints.um.edu.my/id/eprint/36241

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