Younger patients on state insurance are at the highest risk of readmission in a lupus hospital

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Najjar does not report relevant financial disclosures. Please see the financial disclosure study of all other authors.

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The strongest risk factors for 30 days of hospital treatment in patients with systemic lupus erythematosus are younger age, social security benefits and SLE-related events, according to data from Arthritis care and research.

“The study was conceived in the last few months of my residency training before I started a scholarship in rheumatology; I was eager to apply my previous experience in clinical epidemiology to the study of rheumatic diseases. Ryan Najjar, Ph.D., MPH, from the University of Washington in Seattle, the lead author of the study told Healio. “The study uses the national readmission database to assess independent readmission risk factors in a sample of SLE patients.


According to the data, the strongest risk factors for 30-day hospital treatment for patients with SLE are younger age, social security benefits and SLE-related events.

To identify individual risk factors that could predict hospital readmission, Nijar and colleagues analyzed data from the National Readmission Database (NRD) of the Health Care Expenditure and Use Project. The database contains information on 36 million discharges from 28 states in the United States, the researchers wrote.

The study included adult patients hospitalized with SLE who were discharged between January and November 2016 and 2017. Patients diagnosed with lupus erythematosus alone were not included in the study. In addition, the authors do not include patients who do not have information on the length of stay or data on expected payers, as well as patients who have stayed for 30 days or more. The researchers used the data to identify patients’ first readmission within 30 days of discharge. The 40 most common cases of readmission and readmission costs were recorded.

Following the exceptions, 71,213 patients with SLE were admitted and included in the analysis. Among these patients, 18,973 were re-admitted within 30 days of their initial discharge. Compared to patients who were not re-admitted to the hospital within 30 days, patients who were re-admitted were younger, had a higher coverage rate of Medicare or Medicaid (P (.0001) and show more glomerular diseases, pleurisy and thrombocytopenia, according to researchers.

More than 50% of readmission occurred by day 11. Other variables associated with increased levels of readmission include age 18 to 30 years, compared with those over 65 years (OR = 1.28; 95% CI, 1.17-1.41), glomerular age. disease (OR = 1.27; 95% CI, 1.19-1.36), congestive heart failure (OR = 1.34; 95% CI, 1.24-1.44), pericarditis (OR = 1, 35; 95% CI, 1.14-1.60), pleurisy (OR = 1.24; 95% CI, 1.10-1.40), psychosis (OR = 1.23; 95% CI, 1, 11-1.37) and autoimmune hemolytic anemia (OR = 1.74; 95% CI, 1.41–2.16).

“We found that the strongest risk factors for a 30-day readmission were younger age, SLE-related manifestations, and social security,” Nijar said.

“These results identify groups of patients with SLE who would benefit from post-discharge interventions designed to reduce hospitalizations and improve health outcomes,” Nijar added. “In addition to patient morbidity leading to readmission, we consider the cost and duration of readmission, which highlights the importance of early post-hospitalization as a potential area for improving health outcomes and alleviating the impact on the health care system.”

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