Hospital admissions and disease outcomes in systemic lupus erythematosus: a retrospective study from a tertiary rheumatology care unit

Abstract Objective To evaluate the clinical and laboratory characteristics associated with disease outcomes and mortality in systemic lupus erythematosus (SLE) patients admitted to a specialized rheumatology care unit. Methods A retrospective cohort study was conducted on 89 patients with SLE admitted between May 2022 and May 2023. Demographic data, comorbidities, clinical presentations, laboratory parameters, and disease activity (SLEDAI) and damage (SLICC/ACR) indices were analyzed. Causes of admission, types of infections, therapeutic interventions, and in-hospital outcomes were also assessed. Results The majority of patients were female (97.8%) with a mean age of 34.96 ± 13.78 years. Infection was the leading cause of admission (51.7%), with bacterial infections accounting for 84% of all infections. Hypertension was the most common comorbidity (37.1%). Disease activity was high, with 51.7% experiencing a severe flare (SLEDAI > 12). Irreversible damage was noted in 70.8% of patients (SLICC/ACR score ≥ 1). The in-hospital mortality rate was 6.7%, with cardiovascular complications responsible for 50% of deaths. Glucocorticoids were administered to nearly all patients (98.9%), while immunosuppressants such as mycophenolate mofetil and cyclophosphamide were used selectively. Conclusion SLE hospitalizations are frequently driven by infectious complications, with bacterial sepsis being predominant. Cardiovascular complications remain the primary cause of death in this population. Improved infection monitoring and proactive cardiovascular risk management are essential to reduce morbidity and mortality in SLE patients requiring hospitalization.