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Objective:  To identify factors associated with mortality in SLE patients who were hospitalized for pulmonary infections (PIs).   Methods:  This single-center retrospective study analyzed the characteristics and risk factors for mortality in 95 SLE patients hospitalized for PIs.   Results:  Ninety-five SLE patients had 97 episodes of hospitalization for PIs, and 33 of these episodes (34.02%) led to death. Death from PI was associated with a higher neutrophil count (6.30 vs. 4.201 × 10 9 /L,  p  < 0.01), immunoglobulin G (6.20 vs. 9.82 g/L,  p  = 0.01), serum creatinine (126.00 vs. 73.00 μmol/L,  p  = 0.01), proteinuria (2.99 vs. 0.54 g/day,  p  < 0.01), cardiopulmonary involvement (57.58 vs. 34.38%,  p  < 0.05), SLE disease activity index (SLEDAI; 11.00 vs. 6.00,  p  < 0.05), and opportunistic infections (78.79 vs. 45.31%,  p  < 0.05). Demographic characteristics, antibody/complements, bacterial infection, and primary treatment before infection (including corticosteroid and immunosuppressants) had no effect. Multivariate analysis indicated cardiopulmonary involvement (HR: 2.077; 95%CI: 1.022–4.220;  p  = 0.043) and opportunistic infection (HR: 2.572; 95%CI: 1.104–5.993;  p  = 0.029) were independent risk factors for mortality. High-dose steroid pulse therapy (HR: 0.982; 95%CI: 0.410–2.350;  p  = 0.982) and first-line immunosuppressant therapy (HR: 1.635; 95%CI: 0.755–3.542,  p  = 0.212) had no effect on mortality.   Conclusion:  Cardiopulmonary involvement and opportunistic infection were independent risk factors for mortality for SLE patients hospitalized for PIs. Use of high-dose pulse steroids and or immunosuppressants before hospitalization had no significant effects.

Clinical Characteristics and Prognoses of Patients With Systemic Lupus Erythematosus Hospitalized for Pulmonary Infections