Significant Reductions in Mortality in Hospitalized Patients with Systemic Lupus Erythematosus in Washington State from 2003 to 2011

<div><p>Background</p><p>Systemic lupus erythematosus (SLE or lupus) is an autoimmune multisystem disease. While a complete understanding of lupus’ origins, mechanisms, and progression is not yet available, a number of studies have demonstrated correlations between disease prevalence and severity, gender, and race. There have been few population based studies in the United States</p><p>Objectives</p><p>To assess temporal changes in demographics and hospital mortality of patients with lupus in Washington State from 2003 to 2011</p><p>Study Design</p><p>This study used data from the Healthcare Cost and Utilization Project (HCUP), a patient information database, and data from the Washington State census to study a group of patients in the state. Lupus hospitalizations were defined as any hospitalization with an ICD-9-CM diagnosis code for systemic lupus erythematosus. Regression analysis was used to assess the effect of calendar time on demographics and hospital outcomes.</p><p>Results</p><p>There were a total of 18,905 patients in this study with a diagnostic code for lupus. The mean age of the group was 51.5 years (95% CI: 50.6-52.3) in 2003 and 51.3 years (95% CI: 50.6-52.0) in 2011. The population was 88.6% female. Blacks were 2.8 times more likely to have a lupus hospitalization than whites when compared to the Washington population. While hospital mortality decreased during this eight year period (3.12% in 2003 to 1.28% in 2011, p=0.001) hospital length of stay remained statistically unchanged at an average of 4.9 days during that eight year period. We found a significant decrease in annual hospital mortality over the study period [odds ratio(OR): 0.92 per year, 95% CI 0.88-0.96, P<0.001]. Hospital mortality was higher in males (2.6% male death to 1.8% female death)</p><p>Conclusions</p><p>In this large group of hospitalized lupus patients in Washington, hospital length of stay remained relatively stable over time but hospital mortality decreased by over 50% over the eight year study period.</p></div

The percentage of lupus patients hospitalized every year by gender, age category, and hospital mortality and mean length of stay in Washington State from years 2003 through 2011.

<p>The percentage of lupus patients hospitalized every year by gender, age category, and hospital mortality and mean length of stay in Washington State from years 2003 through 2011.</p

Prevalence of lupus hospitalizations in Hispanics and non-Hispanics based on Washington State population estimates, 2008 through 2011.

<p>Prevalence of lupus hospitalizations in Hispanics and non-Hispanics based on Washington State population estimates, 2008 through 2011.</p

Prevalence of lupus hospitalizations by race based on Washington State population estimates, 2008 through 2011.

<p>Prevalence of lupus hospitalizations by race based on Washington State population estimates, 2008 through 2011.</p