Abstract 18750: Systemic Lupus Erythematosus is Associated With Higher In-hospital Mortality Among Patients Hospitalized With Heart Failure: Findings From a United States National Study
Background: The association between systemic lupus erythematosus (SLE) and heart failure (HF) has been primarily described in case reports and case series. However, the relationship between SLE and clinical outcomes among patients hospitalized for HF has not been systemically evaluated in real-world setting.
Hypothesis: SLE diagnosis is associated with higher in-hospital mortality among patients hospitalized for acute HF.
Methods: We used the Nationwide Inpatient Sample (NIS) database to evaluate adult patients who were primarily hospitalized for HF (ICD 9 code 428.xx). Discharge weights were used to enable national estimates. Of 11,992,861 patients hospitalized for HF between 2002-2012, 50,878 (0.4%) had SLE. Logistic regression was used to evaluate the association between SLE and in-hospital mortality among these patients.
Results: Patients hospitalized for HF had a mean age of 73 (±14) years, 52% were women and 68% were whites. Compared with hospitalized HF patients without SLE, those with SLE were younger (60 years vs. 73 years, P<0.001), more likely to be female and of black race. In-hospital mortality occurred in 2.9% and 3.5% of hospitalized HF patients with and without SLE respectively (unadjusted OR for in-hospital mortality, when HF patients with SLE was compared with HF patients without SLE, 0.81; 95% CI, 0.77-0.85; P <0.001). After adjusting only for age, SLE independently increased risk of in-hospital mortality among HF patients (age adj. OR, 1.22; 95% CI, 1.16-1.28; P <0.001). The association remained statistically significant after adjusting for other patient demographics, risk factors and hospital characteristics (adjusted OR, 1.08; 95% CI, 1.01-1.15; P = 0.019). When compared with HF patients without SLE, those with SLE had a higher mean length of stay (5.68 vs 5.34 days) and higher hospitalization charges ($ 33,330 vs $ 31,098) (all p-values <0.001).
Conclusions: In this nation-wide study, prevalence of SLE was low among hospitalized HF patients. SLE was independently associated with increased risk of in-hospital mortality, prolonged hospital stay and increased total hospital charge. Further prospective studies are needed to better understand the relationship in this high-risk population.
Author Disclosures: N.K. Mazumder: None. M. Mujib: None. W.S. Aronow: None. T. Gupta: None. N. Paul: None. D. Kolte: None. S. Khera: None. P. Harikrishnan: None. C. Palaniswamy: None. S. Sule: None. A. Ahmed: None. W.H. Frishman: None. D. Jain: None. H.A. Cooper: None. G.C. Fonarow: Consultant/Advisory Board; Modest; Medtronic, Amgen, Johnson & Johnson, Bayer, Boston Scientific. Research Grant; Significant; NIH. Consultant/Advisory Board; Significant; Novartis. J.A. Panza: None.
- © 2015 by American Heart Association, Inc.