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Characteristics and risk factors of an emergency department visit in patients with systemic lupus erythematosus

  • Observational Research
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Abstract

This study aimed to examine the characteristics of patients with systemic lupus erythematosus (SLE) visiting the emergency department (ED) and the risk factors of an ED visit by these patients. This 4-year retrospective study was performed at a tertiary care center in Japan. We included all 205 patients with SLE who were treated in our outpatient clinic between April 1, 2008 and March 31, 2012 and divided them into two groups: those who visited the ED (the ED-user group) and those who did not (the ED-non-user group). We statistically compared the patient backgrounds and characteristics of the groups and identified the risk factors of an ED visit. Of all the patients, 118 visited the ED during study period and 87 did not. In total, 269 events were identified in the ED-user group. Of these, 91 (33.8%) were cases of infection, 32 (11.9%) were orthopedic problems, 32 (11.9%) were cases of gastrointestinal disease, 31 (11.5%) were cases of neurological disease, and 25 (9.3%) were cardiovascular events. Twenty-four events (8.9%) were due to SLE flares, of which ten (41.7%) were cases of neuropsychiatric lupus (NPSLE). The glucocorticoid dosage and the presence of a psychiatric illness, NPSLE, and lupus nephritis were higher among the ED-user group. Multivariate logistic regression analysis demonstrated high glucocorticoid dosage to be a risk factor of an ED visit. Among SLE patients, infections were the principal reason for visiting the ED. The most common reasons for an ED visit were common diseases rather than flares.

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Acknowledgements

The authors thank James R. Valera for his assistance with editing the manuscript.

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Authors and Affiliations

  1. Department of Rheumatic Diseases, Tokyo Metropolitan Tama Medical Center, 2-8-29 Musashidai, Fuchu-shi, Tokyo, 183-8524, Japan

    Yoshiki Nagai, Naoto Yokogawa, Kota Shimada & Shoji Sugii

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  1. Yoshiki Nagai
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  2. Naoto Yokogawa
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  3. Kota Shimada
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  4. Shoji Sugii
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Contributions

YN designed the study, collected the date, drafted and revised the manuscript. NY participated in designing the study, interpreted the date. KS participated interpreted the data and revised the manuscript. SS designed the study and interpreted the data. All the authors read and approved the final manuscript.

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Correspondence to Yoshiki Nagai.

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All authors declare that there are no conflicts of interest.

Ethical standards

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

This study was approved by the Institutional Review Board (IRB) of Tokyo Metropolitan Tama Medical Center (30–46), and the patient’s written informed consent was waived by the approving IRB, as this was a retrospective study.

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Nagai, Y., Yokogawa, N., Shimada, K. et al. Characteristics and risk factors of an emergency department visit in patients with systemic lupus erythematosus. Rheumatol Int 39, 1567–1573 (2019). https://doi.org/10.1007/s00296-019-04377-7

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  • DOI: https://doi.org/10.1007/s00296-019-04377-7

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