Generic placeholder image

Current Rheumatology Reviews


ISSN (Print): 1573-3971
ISSN (Online): 1875-6360

Review Article

Causes of Hospitalization in Systemic Lupus Erythematosus: A Narrative Review

Author(s): Gilberto Pires da Rosa*, Ricard Cervera and Gerard Espinosa

Volume 17, Issue 1, 2021

Published on: 27 July, 2020

Page: [29 - 40] Pages: 12

DOI: 10.2174/1573397116666200727145818

Price: $65


Hospitalizations are frequent in Systemic Lupus Erythematosus (SLE) and carry a significant economic burden. The focus of this review was to summarize the information available on the main causes of SLE hospitalizations over recent decades. A literature review was conducted, using PubMed and Scopus, for articles related to SLE hospital admissions from 1981 onward. Active disease/ flare and infection were the leading causes of admission across the study period. More recently, other comorbidities gained relevance, such as cardio and cerebrovascular disease, pregnancy-related morbidity, adverse drug reactions, thromboembolic events, malignancy and renal, pulmonary and gastrointestinal disease. African and Southeast Asian studies seemed to display particularly high percentages of patients admitted with active disease/flare, while European and North American studies appeared to report more admissions due to comorbidities and accumulated disease/treatment damage. Some data support a temporal change of certain admission causes, but the limited number, heterogeneity and variance among studies weakens a consistent analysis. In conclusion, despite the developments in SLE management, causes of hospitalization have not prominently changed across recent decades.

Keywords: Systemic lupus erythematosus, hospitalization, admission, flare, infection, cardiovascular, comorbidities.

Teh CL, Chan GYL, Lee J. Systemic lupus erythematosus in a tertiary, east Malaysian hospital: admission, readmission and death. Int J Rheum Dis 2008; 11(1): 24-9.
Edwards CJ, Lian TY, Badsha H, Teh CL, Arden N, Chng HH. Hospitalization of individuals with systemic lupus erythematosus: characteristics and predictors of outcome. Lupus 2003; 12(9): 672-6.
[ ] [PMID: 14514129]
Pacheco D, Alvarez ME, Vizcarra G, Fuentealba C, Marinovic MA, Ballesteros F. Características de la hospitalización reumatológica en un hospital de nivel terciario. Rev Med Chil 2001; 129(6): 653-9.
[ ] [PMID: 11510206]
Lee JW, Park DJ, Kang JH, et al. The rate of and risk factors for frequent hospitalization in systemic lupus erythematosus: results from the Korean lupus network registry. Lupus 2016; 25(13): 1412-9.
[ ] [PMID: 27000153]
Lee J, Dhillon N, Pope J. All-cause hospitalizations in systemic lupus erythematosus from a large Canadian referral centre. Rheumatology (Oxford) 2013; 52(5): 905-9.
[ ] [PMID: 23307831]
Chakravarty EF, Bush TM, Manzi S, Clarke AE, Ward MM. Prevalence of adult systemic lupus erythematosus in California and Pennsylvania in 2000: estimates obtained using hospitalization data. Arthritis Rheum 2007; 56(6): 2092-4.
[ ] [PMID: 17530651]
Busch RW, Kay SD, Voss A. Hospitalizations among Danish SLE patients: a prospective study on incidence, causes of admission and risk factors in a population-based cohort. Lupus 2018; 27(1): 165-71.
[ ] [PMID: 29050537]
Liang H, Pan H-F, Tao J-H, Ye D-Q. Causes and factors associated with frequent hospitalization in Chinese patients with systemic lupus erythematosus: An ambispective cohort study. Med Sci Monit 2019; 25: 8061-8.
[ ] [PMID: 31655846]
Rosa GPD, Ortega MF, Teixeira A, Espinosa G, Cervera R. Causes and factors related to hospitalizations in patients with systemic lupus erythematosus: analysis of a 20-year period (1995-2015) from a single referral centre in Catalonia. Lupus 2019; 28(9): 1158-66.
[ ] [PMID: 31299879]
Petri M, Genovese M. Incidence of and risk factors for hospitalizations in systemic lupus erythematosus: a prospective study of the Hopkins Lupus Cohort. J Rheumatol 1992; 19(10): 1559-65.
[PMID: 1464868]
Anastasiou C, Dulai O, Baskaran A, Proudfoot J, Verhaegen S, Kalunian K. Immunosuppressant use and hospitalisations in adult patients with systemic lupus erythematosus admitted to a tertiary academic medical centre. Lupus Sci Med 2018; 5(1)e000249
[ ] [PMID: 29955368]
Gu K, Gladman DD, Su J, Urowitz MB. Hospitalizations in patients with systemic lupus erythematosus in an academic health science center. J Rheumatol 2017; 44(8): 1173-8.
[ ] [PMID: 28620060]
Slawsky KA, Fernandes AW, Fusfeld L, Manzi S, Goss TF. A structured literature review of the direct costs of adult systemic lupus erythematosus in the US. Arthritis Care Res (Hoboken) 2011; 63(9): 1224-32.
[ ] [PMID: 21584945]
Clarke AE, Urowitz MB, Monga N, Hanly JG. Costs associated with severe and nonsevere systemic lupus erythematosus in Canada. Arthritis Care Res (Hoboken) 2015; 67(3): 431-6.
[ ] [PMID: 25185936]
Anandarajah AP, Luc M, Ritchlin CT. Hospitalization of patients with systemic lupus erythematosus is a major cause of direct and indirect healthcare costs. Lupus 2017; 26(7): 756-61.
[ ] [PMID: 27831537]
Yazdany J, Marafino BJ, Dean ML, et al. Thirty-day hospital readmissions in systemic lupus erythematosus: predictors and hospital- and state-level variation. Arthritis Rheumatol 2014; 66(10): 2828-36.
[ ] [PMID: 25110993]
Levy O, Markov A, Drob Y, Maslakov I, Tishler M, Amit-Vazina M. All-cause hospitalizations in systemic lupus erythematosus from a single medical center in Israel. Rheumatol Int 2018; 38(10): 1841-6.
[ ] [PMID: 30151719]
Teh CL, Ling GR. Causes and predictors of mortality in hospitalized lupus patient in Sarawak General Hospital, Malaysia. Lupus 2013; 22(1): 106-11.
[ ] [PMID: 23112253]
Jallouli M, Hriz H, Cherif Y, et al. Causes and outcome of hospitalisations in Tunisian patients with systemic lupus erythematosus. Lupus Sci Med 2014; 1(1)e000017
[ ] [PMID: 25396063]
Ali Alasmari MSSALABANGRA, Abdullah Alsabaani AAFA. Causes and outcomes of hospitalization among systemic lupus erythematosus patients in aseer central hospital, saudi arabia: a retrospective study. Egyptian J Hospital Med 2018; 71(1): 2358-64.
Dubula T, Mody GM. Spectrum of infections and outcome among hospitalized South Africans with systemic lupus erythematosus. Clin Rheumatol 2015; 34(3): 479-88.
[ ] [PMID: 25535200]
Piga M, Casula L, Perra D, et al. Population-based analysis of hospitalizations in a West-European region revealed major changes in hospital utilization for patients with systemic lupus erythematosus over the period 2001-2012. Lupus 2016; 25(1): 28-37.
[ ] [PMID: 26199283]
Krishnan E. Hospitalization and mortality of patients with systemic lupus erythematosus. J Rheumatol 2006; 33(9): 1770-4.
[PMID: 16832848]
Zimlichman E, Rothschild J, Shoenfeld Y, Zandman-Goddard G. Good prognosis for hospitalized SLE patients with non-related disease. Autoimmun Rev 2014; 13(11): 1090-3.
[ ] [PMID: 25182206]
Dhital R, Pandey RK, Poudel DR, Oladunjoye O, Paudel P, Karmacharya P. All-cause hospitalizations and mortality in systemic lupus erythematosus in the US: results from a national inpatient database. Rheumatol Int 2020; 40(3): 393-7.
[ ] [PMID: 31773392]
Dzifa D, Boima V, Yorke E, Yawson A, Ganu V, Mate-Kole C. Predictors and outcome of systemic lupus erythematosus (SLE) admission rates in a large teaching hospital in sub-Saharan Africa. Lupus 2018; 27(2): 336-42.
[ ] [PMID: 29173007]
Barahona-López D, Sánchez-Sierra L, Matute-Martínez C, Barahona-López I, Perdomo-Vaquero R, Erazo-Trimarchi G. ospitalización en lupus eritematoso sistémico: causas, actividad lúpica y evolución Medicina interna de México 2017.33: 730-8.
Rojas-Serrano J, Cardiel MH. Lupus patients in an emergency unit. Causes of consultation, hospitalization and outcome. A cohort study. Lupus 2000; 9(8): 601-6.
[ ] [PMID: 11035435]
Muñoz-Grajales C, Velásquez Franco CJ, Márquez Hernández JD, Pinto Peñaranda LF. Hospitalización en lupus eritematoso sistémico: causas, evolución, complicaciones y mortalidad. Revista Colombiana de Reumatología 2014; 21: 65-9.
Jordán-González P, Shum LM, González-Sepúlveda L, Vilá LM. Clinical correlates and outcomes in a group of Puerto Ricans with systemic lupus erythematosus hospitalized due to severe infections. SAGE Open Med 2018; 62050312118778385
[ ] [PMID: 29844913]
Han G-M, Han X-F. Comorbid conditions are associated with emergency department visits, hospitalizations, and medical charges of patients with systemic lupus erythematosus. J Clin Rheumatol 2017; 23(1): 19-25.
[ ] [PMID: 28002152]
Reátegui-Sokolova C, Rodríguez-Bellido Z, Gamboa-Cárdenas RV, et al. Remission and low disease activity state prevent hospitalizations in systemic lupus erythematosus patients. Lupus 2019; 28(11): 1344-9.
[ ] [PMID: 31551028]
Esmaeilzadeh E, Khodamoradi Z, Nazarinia MA. One-decade study of distinct features, morbidity and mortality of systemic lupus erythematosus (an update on systemic lupus erythematosus in the Fars Province of Iran). Lupus 2019; 28(11): 1360-7.
[ ] [PMID: 31382851]
Tektonidou MG, Wang Z, Dasgupta A, Ward MM. Burden of serious infections in adults with systemic lupus erythematosus: A National Population-Based Study, 1996-2011. Arthritis Care Res (Hoboken) 2015; 67(8): 1078-85.
[ ] [PMID: 25732901]
Murray SG, Schmajuk G, Trupin L, Gensler L, Katz PP, Yelin EH, et al. National lupus hospitalization trends reveal rising rates of herpes zoster and declines in pneumocystis pneumonia. PLoS One; 2016; 11(1)e0144918-e.
Tektonidou MG, Wang Z, Ward MM. Brief report: Trends in hospitalizations due to acute coronary syndromes and stroke in patients with Systemic Lupus Erythematosus, 1996 to 2012. Arthritis Rheumatol 2016; 68(11): 2680-5.
[ ] [PMID: 27273732]
Hernández Bernardino G, Sánchez Navarro LM, León Tapia S, Cruz Hernández V, Pérez Campos E, Martínez Luna MS. Systemic lupus erythematosus. Clinical findings in 31 hospitalized patients. Dermatologia Cosmetica. Medica y Quirurgica 2007; 5(4): 188-94.

Rights & Permissions Print Export Cite as
© 2024 Bentham Science Publishers | Privacy Policy