Outcomes of systemic lupus erythematosus hospitalisations in Qatar: Insights from a multinational tertiary centre experience

ObjectiveSystemic lupus erythematosus (SLE) is a chronic autoimmune disorder associated with considerable morbidity and mortality, particularly due to frequent hospitalisations. This study aimed to describe the causes, clinical course, and outcomes of hospitalisations among patients with SLE in a multinational cohort.MethodsThis retrospective cohort included adults (aged ≥18 years) with SLE hospitalised at Hamad General Hospital, Qatar, between June 2016 and August 2020. Each admission was considered separately. Data included demographics, clinical features, SLE Disease Activity Index (SLEDAI), serological markers, complications, treatments, and prognoses. Predictors of intensive care unit (ICU) admission were evaluated using univariable and multivariable logistic regression.ResultsThere were 281 admissions among 153 patients. Most patients (87%) were female, with a median age of 34 years (IQR: 26-44). The principal causes of admission were lupus flares, haematologic (38%), renal (28%), and articular (20%), followed by infection (20%). The median hospital stay was 7 days (IQR: 4-12). Re-admission occurred in 51% of the patients, and 17% of the admissions required ICU care. ICU admission was associated with a longer hospital stay (median 16 vs 6 days, p < 0.001) and higher mortality (11% vs 0%, p < 0.001). Factors predicting ICU admission were a higher SLEDAI score (odds ratio (OR) 1.14, 95% confidence interval (CI)1.07-1.21, p < 0.001), sepsis (OR 4.91, 95% CI 2.02-11.89, p < 0.001), and cardiac involvement (OR 7.57, 95% CI 1.74-32.93, p = 0.007).ConclusionsIn this multinational cohort, SLE flares and infections were the leading causes of hospitalisation. Sepsis, comorbid conditions, and high disease activity are associated with adverse outcomes. Optimising disease control, preventing infection, and managing comorbidities are essential to improve hospitalisation outcomes and reduce mortality.