Prediction of Hospitalizations in Systemic Lupus Erythematosus Using the Systemic Lupus International Collaborating...

Area of Science:

• Rheumatology
• Clinical Epidemiology

Background:

• The Systemic Lupus International Collaborating Clinics (SLICC) frailty index (FI) is established for predicting mortality and damage in systemic lupus erythematosus (SLE).
• The association between the SLICC-FI and hospitalization rates in SLE patients has not been previously described.

Purpose of the Study:

• To evaluate the association between baseline SLICC-FI values and future hospitalizations within the SLICC inception cohort.
• To determine if the SLICC-FI can predict the frequency and duration of hospitalizations in SLE patients.

Main Methods:

• Baseline SLICC-FI scores were calculated for 1,549 SLE patients.
• Inpatient hospitalizations and duration were recorded during a mean follow-up of 7.2 years.
• Negative binomial and linear regression models were used to assess the association of SLICC-FI with hospitalization rates and time spent hospitalized, adjusting for covariates.

Main Results:

• Higher baseline SLICC-FI values were significantly associated with more frequent hospitalizations (IRR 1.21, 95% CI 1.13-1.30) per 0.05 increment.
• Among hospitalized patients, higher SLICC-FI predicted a greater proportion of follow-up time spent hospitalized (RR 1.09, 95% CI 1.02-1.16).
• 39.6% of patients experienced 1,570 hospitalizations during the study period.

Conclusions:

• The SLICC-FI is a valid measure for predicting future hospitalizations in incident SLE patients.
• These findings support the utility of the SLICC-FI as a comprehensive health assessment tool in SLE management.