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. 2021 Dec 8;10(24):5749.
doi: 10.3390/jcm10245749.

Trends in Hospital Admissions and Death Causes in Patients with Systemic Lupus Erythematosus: Spanish National Registry

Affiliations

Trends in Hospital Admissions and Death Causes in Patients with Systemic Lupus Erythematosus: Spanish National Registry

Víctor Moreno-Torres et al. J Clin Med. .

Abstract

Background: the admission and death causes of SLE patients might have changed over the last years.

Methods: Analysis of the Spanish National Hospital Discharge database. All individuals admitted with SLE, according to ICD-9, were selected. The following five admission categories were considered: SLE, cardiovascular disease (CVD), neoplasm, infection, and venous-thromboembolic disease (VTED), along four periods of time (1997-2000, 2001-2005, 2006-2010, and 2011-2015).

Results: The admissions (99,859) from 43.432 patients with SLE were included. The absolute number of admissions increased from 15,807 in 1997-2000 to 31,977 in 2011-2015. SLE decreased as a cause of admission (from 47.1% to 20.8%, p < 0.001), while other categories increased over the time, as follows: 5% to 8.6% for CVD, 8.2% to 13% for infection, and 1.4% to 5.5% for neoplasm (p < 0.001 for all). The admission mortality rate rose from 2.22% to 3.06% (p < 0.001) and the causes of death evolved in parallel with the admission categories. A significant trend to older age was observed over time in the overall population and deceased patients (p < 0.001).

Conclusions: Better control of SLE over the past two decades has led to a decrease in early admissions, and disease chronification. As a counterpart, CVD, infections, and neoplasm have become the main causes of admissions and mortality.

Keywords: cardiovascular disease; hospital admissions; infections; mortality; neoplasm; systemic lupus erythematosus.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Cardiovascular disease admissions and deaths. The figure shows the trends in admissions (A) and deaths (B) for cardiovascular disease. Data are expressed as a percentage of total admissions and deaths for cardiovascular disease (left ordered axis) and for the subgroups that comprise cardiovascular disease (right ordered axis).
Figure 2
Figure 2
Infectious disease admissions and deaths. The figure shows the trends in admissions (A) and deaths (B) because of infection. Data are expressed as a percentage of total admissions and deaths for the overall infections (left ordered axis) and for the subgroups that comprise infectious disease (right ordered axis).
Figure 3
Figure 3
Neoplasm admissions and deaths. The figure shows the trends in admissions (A) and deaths (B) because of neoplasm. Data are expressed as a percentage of total admissions and deaths for the overall neoplasms (left ordered axis) and for the benign, solid organ, hematological and unknown origin neoplasm (ordered axis).

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