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Prediction of Hospitalizations in Systemic Lupus Erythematosus Using the Systemic Lupus International Collaborating Clinics Frailty Index
Author(s) -
Legge Alexandra,
Kirkland Susan,
Rockwood Kenneth,
Andreou Pantelis,
Bae SangCheol,
Gordon Caroline,
RomeroDiaz Juanita,
SanchezGuerrero Jorge,
Wallace Daniel J.,
Bernatsky Sasha,
Clarke Ann E.,
Merrill Joan T.,
Ginzler Ellen M.,
Fortin Paul R.,
Gladman Dafna D.,
Urowitz Murray B.,
Bruce Ian N.,
Isenberg David A.,
Rahman Anisur,
Alarcón Graciela S.,
Petri Michelle,
Khamashta Munther A.,
Dooley M. A.,
RamseyGoldman Rosalind,
Manzi Susan,
Zoma Asad A.,
Aranow Cynthia,
Mackay Meggan,
RuizIrastorza Guillermo,
Lim S. Sam,
Inanc Murat,
Vollenhoven Ronald F.,
Jonsen Andreas,
Nived Ola,
RamosCasals Manuel,
Kamen Diane L.,
Kalunian Kenneth C.,
Jacobsen Søren,
Peschken Christine A.,
Askanase Anca,
Hanly John G.
Publication year - 2022
Publication title -
arthritis care and research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.032
H-Index - 163
eISSN - 2151-4658
pISSN - 2151-464X
DOI - 10.1002/acr.24504
Subject(s) - medicine , interquartile range , systemic lupus erythematosus , cohort , confidence interval , systemic lupus , rheumatology , disease
Objective The Systemic Lupus International Collaborating Clinics (SLICC) frailty index (FI) predicts mortality and damage accrual in systemic lupus erythematosus (SLE), but its association with hospitalizations has not been described. Our objective was to estimate the association of baseline SLICC‐FI values with future hospitalizations in the SLICC inception cohort. Methods Baseline SLICC‐FI scores were calculated. The number and duration of inpatient hospitalizations during follow‐up were recorded. Negative binomial regression was used to estimate the association between baseline SLICC‐FI values and the rate of hospitalizations per patient‐year of follow‐up. Linear regression was used to estimate the association of baseline SLICC‐FI scores with the proportion of follow‐up time spent in the hospital. Multivariable models were adjusted for relevant baseline characteristics. Results The 1,549 patients with SLE eligible for this analysis were mostly female (88.7%), with a mean ± SD age of 35.7 ± 13.3 years and a median disease duration of 1.2 years (interquartile range 0.9–1.5) at baseline. Mean ± SD baseline SLICC‐FI was 0.17 ± 0.08. During mean ± SD follow‐up of 7.2 ± 3.7 years, 614 patients (39.6%) experienced 1,570 hospitalizations. Higher baseline SLICC‐FI values (per 0.05 increment) were associated with more frequent hospitalizations during follow‐up, with an incidence rate ratio of 1.21 (95% confidence interval [95% CI] 1.13–1.30) after adjustment for baseline age, sex, glucocorticoid use, immunosuppressive use, ethnicity/location, SLE Disease Activity Index 2000 score, SLICC/American College of Rheumatology Damage Index score, and disease duration. Among patients with ≥1 hospitalization, higher baseline SLICC‐FI values predicted a greater proportion of follow‐up time spent hospitalized (relative rate 1.09 [95% CI 1.02–1.16]). Conclusion The SLICC‐FI predicts future hospitalizations among incident SLE patients, further supporting the SLICC‐FI as a valid health measure in SLE.