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Outcomes in hospitalized pediatric patients with systemic lupus erythematosus

Mary Beth F Son1, Victor M Johnson, Aimee O Hersh

  • 1Division of Immunology, Boston Children's Hospital, 300 Longwood Ave, Boston, MA 02115. marybeth.son@childrens.harvard.edu.

Pediatrics
|January 1, 2014
PubMed

Insights

Racial and ethnic disparities impact outcomes for children with childhood-onset systemic lupus erythematosus (SLE). Hispanic patients experienced longer hospital stays and higher mortality, while African American race was linked to ICU admissions and death.

Area of Science:

  • Pediatric Rheumatology
  • Health Disparities Research
  • Systemic Lupus Erythematosus (SLE) Studies

Background:

  • Documented outcome disparities exist in adults with systemic lupus erythematosus (SLE).
  • Limited data are available on sociodemographic factors influencing outcomes in childhood-onset SLE.
  • Understanding these disparities is crucial for improving care in pediatric SLE patients.

Purpose of the Study:

  • To investigate associations between sociodemographic factors and hospital admission volume.
  • To examine the relationship between these factors and hospitalization characteristics.
  • To identify risk factors for poor outcomes in patients with childhood-onset SLE.

Main Methods:

  • Analysis of 10,724 admissions for 2775 patients (aged 3–17 years) with SLE from January 2006 to September 2011 using the Pediatric Health Information System.
  • Descriptive statistics and univariable analyses for demographic characteristics, readmissions, and length of stay.
  • Multivariable logistic regression controlling for covariates to assess risk factors for adverse outcomes.

Main Results:

  • Hispanic patients had longer hospital stays, more readmissions, and higher in-hospital mortality.
  • African American race was significantly associated with intensive care unit (ICU) admission.
  • African American race and Hispanic ethnicity were linked to end-stage renal disease and death.

Conclusions:

  • Race and ethnicity are significantly associated with adverse outcomes in hospitalized children with SLE.
  • Hospital volume and location did not show significant associations with patient outcomes.
  • Further research is necessary to fully understand the complex relationship between sociodemographic factors and poor outcomes in childhood-onset SLE.
Abstract

Keywords:
end-stage renal diseasemortalityoutcomessystemic lupus erythematosus

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