Factors Predictive of In-Hospital Mortality in Patients with Systemic Lupus Erythematosus: A Single-Centre Retrospective Analysis

OBJECTIVE. We aimed to investigate the causes and factors predictive of in-hospital death among patients with systemic lupus erythematosus (SLE) admitted to a tertiary care hospital in Thailand. MATERIALS AND METHODS. We retrospectively reviewed the records of patients with SLE admitted between 2017 and 2021. We collected data related to age, sex, body mass index, comorbidities, disease duration, medication usage, clinical symptoms, vital signs, laboratory results, evidence of infection, presence of systemic inflammatory response syndrome, quick sepsis-related organ assessment scores, and SLE disease activity on the date of admission. The length of hospitalization, treatment administered, and subsequent clinical outcomes (including in-hospital complications and death) were also recorded. RESULTS. Among 267 enrolled patients, the overall in-hospital mortality rate was 25.5%, and infection was the most common cause of death (75.0%). Multivariate analysis revealed that prior hospitalization within 3 months (odds ratio [OR]: 2.311; 95% confidence interval [CI]: 1.002–5.369; P=0.049), initial infection on admission (OR: 2.764; 95% CI: 1.006–7.594; P=0.048), use of vasopressor drugs (OR: 2.940; 95% CI: 1.071–8.069; P=0.036), and mechanical ventilation (OR: 5.658; 95% CI: 2.046–15.647; P=0.001) were independent risk factors for in-hospital mortality. CONCLUSION. Infection was the major cause of mortality in patients with SLE. Prior hospitalization within 3 months, initial infection on admission, vasopressor use, and mechanical ventilation during admission are independent risk factors for in-hospital mortality in patients with SLE.