Systemic Lupus International Collaborating Clinics-Frailty Index predicts hospitalisations in the Almenara Lupus Cohort

Abstract

Objectives To evaluate the Systemic Lupus International Collaborating Clinics-Frailty Index (SLICC-FI) as a predictor of hospitalisations in patients with SLE from a Latin American cohort. Methods Patients from a single-centre prevalent cohort were included. The SLICC-FI was assessed at baseline. Hospitalisations, their number as well as their duration (in days), were reported during the first 3 years from the baseline visit. Univariable and multivariable negative binomial regressions were performed to determine the association between the baseline SLICC-FI (per 0.05 increase) and hospitalisations during follow-up (number and length), adjusted for possible confounders. An alternative analysis was carried out after excluding the damage-related deficits, rendering a modified SLICC-FI. Results Of the 295 patients included, 273 (92.5%) were female, with a mean (SD) age at diagnosis of 34.8 (13.5) years. At baseline, the mean SLICC-FI was 0.18 (0.05) with 86 (29.2%) patients categorised as being frail. The mean number of hospitalisations per patient-year was 0.4 (0.8) and the mean number of days hospitalised during the 3-year period per patient-year was 3.1 (7.6) days. The SLICC-FI predicted a higher number and days of hospitalisations (incidence rate ratio (IRR): 1.671 (95% CI: 1.385 to 2.016) and IRR: 2.018 (95% CI: 1.715 to 2.375), respectively). The modified SLICC-FI also predicted hospitalisations in both number and days. Conclusion The SLICC-FI predicted hospitalisations in patients with SLE, independent of other well-known risk factors. Further studies are needed to develop strategies to improve frailty in these patients.