Staff View: Early damage as measured by SLICC/ACR damage index is a predictor of hospitalization in systemic lupus erythematosus (SLE)

Early damage as measured by SLICC/ACR damage index is a predictor of hospitalization in systemic lupus erythematosus (SLE)

Background Hospital admissions and re-admissions in lupus patients are common occurrences that can lead to poor prognosis. Objectives We evaluated the leading causes of all-cause hospitalizations and their predictive factors in the Malaysian multi-ethnic SLE patients. Methods This is a retrospective...

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Main Authors:	Raman, Leela, Yahya, Fariz, Ng, Choung Min, Sockalingam, Sargunan, Ramasamy, Kuganathan, Ratnam, Ravinash, Raja, Jasmin
Format:	Article
Published:	Arnold Publishers (journals now owned by Sage) 2020
Subjects:	R Medicine Medical technology
Online Access:	http://eprints.um.edu.my/36241/
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spelling	my.um.eprints.362412023-11-29T07:38:50Z http://eprints.um.edu.my/36241/ Early damage as measured by SLICC/ACR damage index is a predictor of hospitalization in systemic lupus erythematosus (SLE) Raman, Leela Yahya, Fariz Ng, Choung Min Sockalingam, Sargunan Ramasamy, Kuganathan Ratnam, Ravinash Raja, Jasmin R Medicine Medical technology Background Hospital admissions and re-admissions in lupus patients are common occurrences that can lead to poor prognosis. Objectives We evaluated the leading causes of all-cause hospitalizations and their predictive factors in the Malaysian multi-ethnic SLE patients. Methods This is a retrospective study involving 300 SLE patients. Demographic data and details of hospitalizations from the year 1988 until 2019 were reviewed. Baseline and latest disease activity (SLEDAI-2 K) and SLICC/ACR damage index (SDI) scores were evaluated. To be eligible for this study, their SLE diagnosis and disease duration was at least one year; this is to ensure that the baseline disease damages were measured at least after 6 months of diagnosis and subsequent disease damage indexes were captured. Results Majority were of Chinese ethnicity 150 (50%). The cohort's median age was 48 (18-82) years and median disease duration was 13 (1-52) years. 133 (44.3%) had SDI score of >= 1 at baseline (early damage). 69 (23%) had developed new organ damage during this study period. There were 222 (74%) patients ever hospitalized from this cohort. The main cause of hospitalization was lupus flare which included concurrent infection (n = 415 admissions, 46%), followed by elective admissions for procedures and others (n = 284 admissions, 31.5%). Admissions for treatment and disease related complications were 13.8%. 8.7% of admissions were due to infections alone. Median length of stay for SLE-related cause admissions was longer compared to non-SLE related causes. Jointly predictive factors for hospitalization were anti-phospholipid syndrome (OR 5.82), anti-Smith (OR 6.30), anti-SSA (OR 3.37), serositis (OR 14.56), neurological (OR 5.52) and high baseline SDI (OR 1.74), all p < 0.05. Conclusion Early damage in lupus as measured by SDI is a predictive value of hospitalization. Optimization in managing patients with pre-existing damage is crucial to reduce hospitalization risk and subsequent complications. Arnold Publishers (journals now owned by Sage) 2020-12 Article PeerReviewed Raman, Leela and Yahya, Fariz and Ng, Choung Min and Sockalingam, Sargunan and Ramasamy, Kuganathan and Ratnam, Ravinash and Raja, Jasmin (2020) Early damage as measured by SLICC/ACR damage index is a predictor of hospitalization in systemic lupus erythematosus (SLE). Lupus, 29 (14). pp. 1885-1891. ISSN 0961-2033, DOI https://doi.org/10.1177/0961203320962848 <https://doi.org/10.1177/0961203320962848>. 10.1177/0961203320962848
institution	Universiti Malaya
building	UM Library
collection	Institutional Repository
continent	Asia
country	Malaysia
content_provider	Universiti Malaya
content_source	UM Research Repository
url_provider	http://eprints.um.edu.my/
topic	R Medicine Medical technology
spellingShingle	R Medicine Medical technology Raman, Leela Yahya, Fariz Ng, Choung Min Sockalingam, Sargunan Ramasamy, Kuganathan Ratnam, Ravinash Raja, Jasmin Early damage as measured by SLICC/ACR damage index is a predictor of hospitalization in systemic lupus erythematosus (SLE)
description	Background Hospital admissions and re-admissions in lupus patients are common occurrences that can lead to poor prognosis. Objectives We evaluated the leading causes of all-cause hospitalizations and their predictive factors in the Malaysian multi-ethnic SLE patients. Methods This is a retrospective study involving 300 SLE patients. Demographic data and details of hospitalizations from the year 1988 until 2019 were reviewed. Baseline and latest disease activity (SLEDAI-2 K) and SLICC/ACR damage index (SDI) scores were evaluated. To be eligible for this study, their SLE diagnosis and disease duration was at least one year; this is to ensure that the baseline disease damages were measured at least after 6 months of diagnosis and subsequent disease damage indexes were captured. Results Majority were of Chinese ethnicity 150 (50%). The cohort's median age was 48 (18-82) years and median disease duration was 13 (1-52) years. 133 (44.3%) had SDI score of >= 1 at baseline (early damage). 69 (23%) had developed new organ damage during this study period. There were 222 (74%) patients ever hospitalized from this cohort. The main cause of hospitalization was lupus flare which included concurrent infection (n = 415 admissions, 46%), followed by elective admissions for procedures and others (n = 284 admissions, 31.5%). Admissions for treatment and disease related complications were 13.8%. 8.7% of admissions were due to infections alone. Median length of stay for SLE-related cause admissions was longer compared to non-SLE related causes. Jointly predictive factors for hospitalization were anti-phospholipid syndrome (OR 5.82), anti-Smith (OR 6.30), anti-SSA (OR 3.37), serositis (OR 14.56), neurological (OR 5.52) and high baseline SDI (OR 1.74), all p < 0.05. Conclusion Early damage in lupus as measured by SDI is a predictive value of hospitalization. Optimization in managing patients with pre-existing damage is crucial to reduce hospitalization risk and subsequent complications.
format	Article
author	Raman, Leela Yahya, Fariz Ng, Choung Min Sockalingam, Sargunan Ramasamy, Kuganathan Ratnam, Ravinash Raja, Jasmin
author_facet	Raman, Leela Yahya, Fariz Ng, Choung Min Sockalingam, Sargunan Ramasamy, Kuganathan Ratnam, Ravinash Raja, Jasmin
author_sort	Raman, Leela
title	Early damage as measured by SLICC/ACR damage index is a predictor of hospitalization in systemic lupus erythematosus (SLE)
title_short	Early damage as measured by SLICC/ACR damage index is a predictor of hospitalization in systemic lupus erythematosus (SLE)
title_full	Early damage as measured by SLICC/ACR damage index is a predictor of hospitalization in systemic lupus erythematosus (SLE)
title_fullStr	Early damage as measured by SLICC/ACR damage index is a predictor of hospitalization in systemic lupus erythematosus (SLE)
title_full_unstemmed	Early damage as measured by SLICC/ACR damage index is a predictor of hospitalization in systemic lupus erythematosus (SLE)
title_sort	early damage as measured by slicc/acr damage index is a predictor of hospitalization in systemic lupus erythematosus (sle)
publisher	Arnold Publishers (journals now owned by Sage)
publishDate	2020
url	http://eprints.um.edu.my/36241/
_version_	1783945849225609216
score	13.211869

Early damage as measured by SLICC/ACR damage index is a predictor of hospitalization in systemic lupus erythematosus (SLE)

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