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FRI0730 The need for hospital admission for systemic lupus erythematosus in western australia leads to a doubling of the all-cause mortality risk as seen in controls, especially for medicare reliant and male patients
  1. WD Raymond1,
  2. D Preen2,
  3. C Inderjeeth1,3,
  4. H Keen4,5,
  5. J Nossent1,6
  1. 1School of Medicine & Pharmacology
  2. 2School of Population Health, University of Western Australia
  3. 3Rehabilitation and Aged Care, Sir Charles Gairdner Hospital
  4. 4Rheumatology, Fiona Stanley Hospital
  5. 5School of Medicine, Murdoch University
  6. 6Rheumatology, Sir Charles Gairdner Hospital, Perth, Australia

Abstract

Background Hospitalisation for Systemic Lupus Erythematosus (SLE) is a significant event.

Objectives We aimed to understand the factors leading to an incident admission and its impact on long term outcome in SLE patients in Western Australia (WA).

Methods Using whole-population data linkage of hospital admissions, cancer registrations and death records in WA from 1980 to 2015, we performed a retrospective comparative analysis for all patients admitted with a first ever primary diagnosis of SLE (ICD-9-CM 695.4, 710.0, ICD-10-AM L93.0 & M32). For SLE patients, we analysed annual incident hospitalisation rates and compared patient characteristics, all-cause mortality and cancer risk (by Kaplan-Meier and Cox regression) versus age- and gender-matched controls free of rheumatic disease.

Results The incident hospitalisation rate for SLE (mean 20.9/million/year (CI: 11–35) showed little variation. SLE patients were younger, more likely to be Indigenous, uninsured, have kidney and cardiovascular disorders and to die during their first hospitalisation (Table 1). Cancer risk was equivalent, but a first admission for SLE doubled the risk of subsequent death (OR=1.99, CI: 1.5– 2.7, p<0.001) (Figure 1/Table 2). Medicare reliance (OR 1.7, CI: 1.4 – 1.9, p=0.001) and male gender (OR 1.4, CI: 1.0 – 1.8, p<0.04) were the strongest independent predictors of death.

Conclusions Hospitalisation rates for SLE in WA have not decreased over 25 years. Once hospital-based management for SLE was required, the risk of all-cause mortality doubled compared to age and gender-matched controls. This risk was greatest in Medicare reliant or male SLE patients and not due to increased cancer risk.

Disclosure of Interest None declared

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