In a cohort of patients with systemic lupus erythematosus in Mexico, disease activity was the main cause of hospital admission. Renal failure, hematologic manifestations, higher C-reactive protein levels, and higher neutrophil counts were all factors associated with hospitalization. On the contrary, the previous use of antimalarial drugs had a protective effect.[1]
Methodology
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A case-control study was performed in 202 patients with systemic lupus erythematosus (88.6% women; median age: 35.8 years). They had consulted the Dr. Ignacio Morones Prieto Central Hospital, in San Luis Potosí, Mexico, during the period 2019 to 2020.
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The analysis of the medical records allowed the collection of data. Renal, hematological, pulmonary, cardiac or other organ involvement due to lupus was evaluated using the Mex-SLEDAI activity index. The control group consisted of 113 patients (55.9%) who received outpatient follow-up. Additionally, through a logistic regression statistical analysis, we sought to identify risk factors associated with greater hospitalization and mortality among participants.
Main results
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Hospitalizations were recorded in 89 (45.1%) patients. Those who made up this group were characterized by being younger (p p
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The main cause of hospitalization was disease activity (60.7% of cases); followed in order of frequency by infections (22.5%), drug toxicity (5.6%) and obstetric morbidity (3.4%), among others. Renal manifestations (69.7%), hematological (38.2%) and constitutional symptoms (32.6%) predominated in this group of patients at the time of admission.
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Furthermore, significant differences were found in baseline laboratory results between both groups. Those who required hospitalization had lower hemoglobins (p ppppp
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In the multivariate logistic regression analysis it was found that the highest levels of creatinine (odds ratio (OR): 2.96; confidence interval [IC] 95%: 1.40 to 8.86; p = 0.018), C-reactive protein (OR 1.16; 95% CI: 0.99 to 1.36; p = 0.046) and neutrophils (OR 1.58; 95% CI: 1.13 to 2.39; p = 0.013) were significantly associated with hospitalization. The presence of constitutional symptoms also acquired statistical significance and was related to the outcome of interest. On the contrary, it was confirmed that the previous use of antimalarials had a protective effect (OR: 0.04).
Clinical approach
“It was hypothesized that a higher disease activity score could be the main risk factor for hospitalization. And it was found that higher creatinine levels and cytopenias were associated with hospitalizations. Some of the results are consistent with other studies “, wrote the authors in the article
Fountain
The research was published in Lupus and its authors are a team made up of members of the Rheumatology Service of the Dr. Ignacio Morones Prieto Central Hospital and the Autonomous University of San Luis Potosí.
Limitations
Study conducted in a single center with a low number of patients. Microbiological examinations are lacking among those who developed infections.
Conflicts of interest
The authors have declared that they have no relevant financial conflicts of interest.
CREDITS
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Cite this article: Risk factors for hospitalization in patients with systemic lupus erythematosus in Mexico – Medscape – June 13, 2024.
