To the Editor:
With great interest we read the article entitled “Hospitalizations in Patients with Systemic Lupus Erythematosus in an Academic Health Science Center” by Gu, et al1. They described the hospitalization of patients with systemic lupus erythematosus (SLE) in an academic hospital over 2- and 3-year periods. They found that incidental causes were most common (35.6%), and that 21.4% and 22.4% of admissions were because of active SLE and infection, respectively. We made a retrospective analysis of 1330 medical records regarding hospitalization of SLE or rheumatoid arthritis (RA) patients in an 18-year period. Table 1 shows the frequency of hospitalization per year, and Table 2 shows the all-cause mortality trends. Of the 467 RA hospital admissions, 5.1% of the patients died, and for the 863 SLE hospital admissions, 22.1% died. In a subgroup analysis in 2008–2009, we found that the mortality-associated factors corresponded to dyspnea as the chief complaint symptom at admission (OR 5.8, 95% CI 1.6–14, p = 0.002) and intensive care admission (OR 9.3, 95% CI 3–29, p = 0.04). Three or more office/control consultations were associated with less mortality (OR 0.59, 95% CI 0.5–0.9, p = 0.03). Advances in the diagnosis and treatment of SLE and RA have reduced the morbidity and mortality of both diseases. Infectious and cardiovascular pathologies were the most frequent causes of death. Considering these factors and the ones addressed by Gu K, et al is of great importance in an academic/university field.
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