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Lupus Patients have high risk of Re-hospitalization

Update Date: Aug 12, 2014 10:00 AM EDT
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Systemic lupus erythematosus (SLE) is a chronic, autoimmune disease that affects the skin, joints, and/or internal organs. Since Lupus is an illness that can flare up and make people feel worse, hospitalizations can be common. In a new study, researchers examined the hospital readmissions rate for Lupus patients. They found that one in six patients are readmitted within a month after discharge.

Lupus occurs when the immune system can no longer differentiate between foreign invaders and the body's own healthy tissue, which triggers the body to produce antibodies to fight and destroy healthy tissue. The autoantibodies are also responsible for inflammation, pain and damage in different parts of the body.

For this study, Dr. Jinoos Yazdany, an associate professor of medicine at the University of California, San Francisco, and colleagues set out to examine why lupus patients have a high rate of re-hospitalization. The team reviewed hospital discharge records taken from more than 800 hospitals in California, Florida, New York, Utah and Washington. The data involved roughly 32,000 patients in 2008 and 2009.

"SLE patients have one of the highest hospital readmission rates compared to those with other chronic illnesses," stated Yazdany reported by Medical Xpress. "Our study is the first large-scale examination of early readmissions following hospitalization due to SLE."

Overall, there were three general causes of hospitalizations. The first cause is the disease itself. The second cause is from other diseases that might coexist with lupus, such as diabetes or heart disease. The last cause is from infections that occur when the immune system is jeopardized by lupus drugs. Based from the rates of these three causes of hospitalizations, the researchers calculated that 16.5 percent of patients were readmitted to the hospitals within 30 days.

"If you have more severe manifestations of the lupus that brought you to the hospital, you're going to be treated with aggressive immunosuppressants, and that's going to increase your risk of infection," said Dr. Joan Merrill, medical director of the Lupus Foundation of America and head of clinical pharmacology research at Oklahoma Medical Research Foundation, reported by WebMD. "That's going to increase your risk of rehospitalization, and/or if the treatments don't work, then you're at risk of organ failure."

Aside from the severity of the illness, the researchers reported that race also played a factor in hospital readmission rates. They reported that black and Hispanic patients were more likely to be re-hospitalized than white patients. Even though the researchers did not uncover why this disparity exists, they reasoned that it could be due to poorer medical care or a lack of access to outpatient care.

"Evidence suggests the rate of readmissions can be reduced by improving discharge planning and the transition process out of the hospital," Yazdany said. "We have a lot of work to do in educating and supporting patients in managing their disease."

The study, "Thirty-day Hospital Readmissions in Systemic Lupus Erythematosus: Predictors and Hospital and State-level Variation," was published in the journal, Arthritis & Rheumatology.

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