Younger, Minority SLE Patients at Higher Risk for Readmission

Yazdany J, Marafino BJ, Dean ML, et al, Thirty-day Hospital Readmissions in Systemic Lupus Erythematosus: Predictors and Hospital and State-level Variation.Arthritis & Rheumatology (2014)  doi: 10.1002/art.38768. Accepted article published online before print.

Black and Hispanic patients with systemic lupus erythematosus (SLE) are more likely than Caucasians to be readmitted within 30 days of a hospitalization, according to a large study of hospital discharge databases.

Women younger than 65 also had a significantly increased risk of readmission, possibly due to more severe disease.

The study of all-cause readmissions included about 56,000 hospitalizations among SLE patients in roughly 85% of US hospitals in five states (California, Florida, New York, Utah, and Washington) between 2008 and 2009. It found that about one in six hospitalized SLE patients were readmitted within 30 days – some repeatedly. Not surprisingly, more severe disease significantly increased the risk of readmission.

Among 4,916 individual patients, those with Medicare or Medicaid were significantly more likely to be readmitted than the 30%  who had private insurance.

Among SLE-related clinical conditions, more than one-third of the 9,244 readmissions were due to lupus nephritis and chronic renal failure. Serositis and thrombocytopenia also triggered readmission.

A different study published earlier this year found that serious infections are leading causes of hospitalization and death in SLE, particularly among patients with lupus nephritis.