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The objective of this study was to evaluate independent risk factors for readmission and determine the major reasons for readmission in a nationally representative sample of patients with systemic lupus erythematosus (SLE).We used the Nationwide Readmissions Database (NRD) to identify adults with SLE who were discharged from hospital to home during January-November of 2016 and 2017. Thirty-day all-cause readmissions were identified. A multivariable adjusted survey-specific logistic regression model was used to identify factors associated with readmission.There were 132,400 hospitalized adults with SLE discharged home during the study period; 88.3% female, with median age of 51.0 years (interquartile range 38.7-61.9). Of these, 18,973 (14.3%) people were readmitted within 30 days of discharge from their index hospitalization. In multivariable analyses, the factors associated with the highest odds for readmission were autoimmune hemolytic anemia [odds ratio (OR) 1.86, 95% CI 1.51-2.29], glomerular disease (OR 1.41, 1.32-1.50), pericarditis (OR 1.40, 1.19-1.66), heart failure (OR 1.38, 1.28-1.49), and age 18-30 years old (OR 1.37, 1.24-1.51, vs age ≥65), Medicare (OR 1.20, 1.13-1.28) and Medicaid insurance (OR 1.26, 1.18-1.34). Sepsis (7.6%), SLE (7.4%), heart failure (3.5%), and pneumonia (3.2%) were among the most common causes for readmission.In this nationally representative study of SLE readmissions, the strongest risk factors for 30-day readmission were younger age, SLE-related manifestations, and public insurance. These results identify patient groups with SLE that would benefit from post-discharge interventions designed to reduce hospitalizations and improve health outcomes. |
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