Predictors of first hospitalization due to disease activity and infections in systemic lupus erythematosus patients

Abstract

Objectives: To identify the predictive factors of first hospitalization and associated variables to the main causes of hospitalizations in lupus patients from a Latin American cohort. Methods: The first hospitalization after entry into the cohort during these patients’ follow-up due to either lupus disease activity and/or infection was examined. Clinical and therapeutic variables were those occurring prior to the first hospitalization. Descriptive statistical tests, multivariable logistic, and Cox regression models were performed. Results: 1341 individuals were included in this analysis; 1200 (89.5%) were women. Their median and interquartile range (IQR) age at diagnosis were 27 (20–37) years and their median and IQR follow up time were 27.5 (4.7–62.2) months. A total of 456 (34.0%) patients were hospitalized; 344 (75.4%), 85 (18.6%) and 27 (5.9%) for disease activity, infections, or both, respectively. The predictors of the first hospitalization regardless of its cause were: medium (HR 2.03(1.27–3.24); p = 0.0028) and low (HR 2.42(1.55–3.79); p < 0.0001) socioeconomic status, serosal (HR 1.32(1.07–1.62); p = 0.0074) and renal (HR 1.50(1.23–1.82); p < 0.0001) involvement. Antimalarial (AM) use (HR 0.61(0.50–0.74); p < 0.0001) and achieving remission (HR 0.80(0.65–0.97); p = 0.0300) were negative predictors. Conclusions: The first hospitalization was associated with worse socioeconomic status and serosal and renal involvement. Conversely, AM use and achieving remission were associated with a lower risk of hospitalizations.