Lung Involvement in Systemic Lupus Erythematosus Linked to Greater Inpatient Mortality

This article is part of Pulmonology Advisor’s coverage of the CHEST Virtual 2020 meeting.

Lung involvement during hospitalization for systemic lupus erythematosus (SLE) may be associated with greater inpatient mortality, according to study results presented at the 2020 CHEST Annual Meeting, held virtually October 18 to 21.

In this study, data from the National Inpatient Sample Database (2016-2017) were examined. This database — the largest for hospitalization data in the United States — gathers data from approximately 1000 hospitals (an estimated 20% of hospitalizations nationwide), and is used as a representative sample.

Hospitalizations for SLE with or without lung involvement as primary or secondary diagnoses of patients aged 18 years or older were searched within the database using International Statistical Classification of Diseases, Tenth Revision codes M32.13 and M32, respectively. The study’s primary outcome was inpatient mortality. Hospital length of stay and total hospital charge were secondary outcomes.

Of 71 million patients within the database hospitalized between 2016 and 2017, 355,750 were for SLE with (n=4870; 1.37%; mean age, 47.68 years) and without (n=350,870; 98.63%; mean age, 52.19 years) lung involvement. Inpatient mortality occurred in 7060 (1.99%) patients hospitalized for SLE (98.05% and 1.95% of patients with and without lung involvement, respectively; adjusted odds ratio, 2.87; 95% CI, 2.08-3.95; P =.0001).

Mean hospital length of stay was 8.31 and 5.46 days for SLE with and without lung involvement, respectively. In an adjusted analysis, SLE with vs without lung involvement was associated with greater hospital length of stay (increase, 2.75 days; 95% CI, 1.93-3.58; P =.0001). In addition, there was an increase in adjusted mean total hospital charges for SLE with lung involvement of $32,658 (95% CI, $21,076-$44,239; P =.0001).

“SLE with lung involvement increases both inpatient mortality and the burden to the healthcare system,” noted the study authors. “These patients require a multidisciplinary approach involving the rheumatologist and pulmonologist to optimize outcomes.”

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Reference

Edigin E, Prado V, Salazar M, and Shaka H. Lung involvement in systemic lupus erythematosus increases inpatient mortality: analysis of the national inpatient sample. Presented at: the CHEST Virtual Annual Meeting, October 18-21, 2020. Abstract 1871.