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. 2014 Jan;133(1):e106-13.
doi: 10.1542/peds.2013-1640. Epub 2013 Dec 30.

Outcomes in hospitalized pediatric patients with systemic lupus erythematosus

Mary Beth F Son  1 , Victor M Johnson, Aimee O Hersh, Mindy S Lo, Karen H Costenbader
Affiliations

Outcomes in hospitalized pediatric patients with systemic lupus erythematosus

Mary Beth F Son et al. Pediatrics. 2014 Jan.

Abstract

Objective: Disparities in outcomes among adults with systemic lupus erythematosus (SLE) have been documented. We investigated associations between sociodemographic factors and volume of annual inpatient hospital admissions with hospitalization characteristics and poor outcomes among patients with childhood-onset SLE.

Methods: By using the Pediatric Health Information System, we analyzed admissions for patients aged 3 to <18 years at index admission with ≥ 1 International Classification of Diseases, Ninth Revision code for SLE from January 2006 to September 2011. Summary statistics and univariable analyses were used to examine demographic characteristics of hospital admissions, readmissions, and lengths of stay. We used multivariable logistic regression analyses, controlling for patient gender, age, race, ethnicity, insurance type, hospital volume, US census region, and severity of illness, to examine risk factors for poor outcomes.

Results: A total of 10,724 admissions occurred among 2775 patients over the study period. Hispanic patients had longer lengths of stay, more readmissions, and higher in-hospital mortality. In multivariable analysis, African American race was significantly associated with ICU admission. African American race and Hispanic ethnicity were associated with end-stage renal disease and death. Volume of patients with SLE per hospital and hospital location were not significantly associated with outcomes.

Conclusions: In this cohort of hospitalized children with SLE, race and ethnicity were associated with outcomes. Further studies are needed to elucidate the relationship between sociodemographic factors and poor outcomes in patients with childhood-onset SLE.

Keywords: end-stage renal disease; mortality; outcomes; systemic lupus erythematosus.

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Conflict of interest statement

FINANCIAL DISCLOSURE: The authors have indicated they have no financial relationships relevant to this article to disclose.

Figures

FIGURE 1. In multivariable analysis controlling for severity of illness, African American patients (odds ratio: 4.15 [95% confidence interval: 1.81–9.50]) and Hispanic patients (odds ratio: 4.55 [95% confidence interval: 2.03–10.22]) were at higher risk for ESRD or death during the study period.
FIGURE 1
In multivariable analysis controlling for severity of illness, African American patients (odds ratio: 4.15 [95% confidence interval: 1.81–9.50]) and Hispanic patients (odds ratio: 4.55 [95% confidence interval: 2.03–10.22]) were at higher risk for ESRD or death during the study period.
See this image and copyright information in PMC

References

    1. Brunner HI , Gladman DD , Ibañez D , Urowitz MD , Silverman ED . Difference in disease features between childhood-onset and adult-onset systemic lupus erythematosus. Arthritis Rheum. 2008;58(2):556–562 - PubMed
    1. Tucker LB , Uribe AG , Fernández M , et al. . Adolescent onset of lupus results in more aggressive disease and worse outcomes: results of a nested matched case-control study within LUMINA, a multiethnic US cohort (LUMINA LVII). Lupus. 2008;17(4):314–322 - PMC - PubMed
    1. Tucker LB , Menon S , Schaller JG , Isenberg DA . Adult- and childhood-onset systemic lupus erythematosus: a comparison of onset, clinical features, serology, and outcome. Br J Rheumatol. 1995;34(9):866–872 - PubMed
    1. Bastian HM , Alarcón GS , Roseman JM , et al. LUMINA Study Group . Systemic lupus erythematosus in a multiethnic US cohort (LUMINA) XL II: factors predictive of new or worsening proteinuria. Rheumatology (Oxford). 2007;46(4):683–689 - PubMed
    1. Hersh AO , Trupin L , Yazdany J , et al. . Childhood-onset disease as a predictor of mortality in an adult cohort of patients with systemic lupus erythematosus. Arthritis Care Res (Hoboken). 2010;62(8):1152–1159 - PMC - PubMed

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