Alexandra Legge1, Susan Kirkland1, Kenneth Rockwood1, Pantelis Andreou1, Sang-Cheol Bae2, Caroline Gordon3, Juanita Romero-Diaz4, Jorge Sanchez-Guerrero4, Daniel J Wallace5, Sasha Bernatsky6, Ann E Clarke7, Joan T Merrill8, Ellen M Ginzler9, Paul R Fortin10, Dafna D Gladman11, Murray B Urowitz11, Ian N Bruce12, David A Isenberg13, Anisur Rahman13, Graciela S Alarcón14, Michelle Petri15, Munther A Khamashta16, M A Dooley17, Rosalind Ramsey-Goldman18, Susan Manzi19, Asad A Zoma20, Cynthia Aranow21, Meggan Mackay21, Guillermo Ruiz-Irastorza22, S Sam Lim23, Murat Inanc24, Ronald F van Vollenhoven25, Andreas Jonsen26, Ola Nived26, Manuel Ramos-Casals27, Diane L Kamen28, Kenneth C Kalunian29, Søren Jacobsen30, Christine A Peschken31, Anca Askanase32, John G Hanly33. 1. Dalhousie University, Halifax, Nova Scotia, Canada. 2. Hanyang University Hospital for Rheumatic Diseases, Seoul, Korea. 3. College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK. 4. Instituto Nacional de Ciencias Médicas y Nutrición, Mexico City, Mexico. 5. Cedars-Sinai/David Geffen School of Medicine at University of California, Los Angeles. 6. McGill University, Montreal, Quebec, Canada. 7. Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada. 8. Oklahoma Medical Research Foundation, Oklahoma City. 9. State University of New York Downstate Medical Center, Brooklyn. 10. CHU de Québec-Université Laval, Quebec City, Quebec, Canada. 11. Toronto Western Hospital and University of Toronto, Toronto, Ontario, Canada. 12. University of Manchester, NIHR Manchester Musculoskeletal Biomedical Research Centre, Manchester University NHS Foundation Trust, and Manchester Academic Health Science Center, Manchester, UK. 13. University College London, London, UK. 14. University of Alabama at Birmingham. 15. Johns Hopkins University School of Medicine, Baltimore, Maryland. 16. St Thomas' Hospital, King's College London School of Medicine, London, UK. 17. University of North Carolina, Chapel Hill. 18. Northwestern University and Feinberg School of Medicine, Chicago, Illinois. 19. Allegheny Health Network, Pittsburgh, Pennsylvania. 20. Hairmyres Hospital, East Kilbride, Scotland, UK. 21. Feinstein Institute for Medical Research, Manhasset, New York. 22. BioCruces Bizkaia Health Research Institute, Hospital Universitario Cruces, and University of the Basque Country, Barakaldo, Spain. 23. Emory University School of Medicine, Atlanta, Georgia. 24. Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey. 25. Karolinska Institute, Stockholm, Sweden. 26. Lund University, Lund, Sweden. 27. Hospital Clínic, Barcelona, Spain. 28. Medical University of South Carolina, Charleston. 29. University of California San Diego School of Medicine, La Jolla. 30. Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. 31. University of Manitoba, Winnipeg, Manitoba, Canada. 32. Hospital for Joint Diseases, New York University, New York. 33. Queen Elizabeth II Health Sciences Center and Dalhousie University, Halifax, Nova Scotia, Canada.
Abstract
OBJECTIVE: The Systemic Lupus International Collaborating Clinics (SLICC) frailty index (FI) predicts mortality and damage accrual in systemic lupus erythematosus (SLE), but its association with hospitalizations has not been described. Our objective was to estimate the association of baseline SLICC-FI values with future hospitalizations in the SLICC inception cohort. METHODS: Baseline SLICC-FI scores were calculated. The number and duration of inpatient hospitalizations during follow-up were recorded. Negative binomial regression was used to estimate the association between baseline SLICC-FI values and the rate of hospitalizations per patient-year of follow-up. Linear regression was used to estimate the association of baseline SLICC-FI scores with the proportion of follow-up time spent in the hospital. Multivariable models were adjusted for relevant baseline characteristics. RESULTS: The 1,549 patients with SLE eligible for this analysis were mostly female (88.7%), with a mean ± SD age of 35.7 ± 13.3 years and a median disease duration of 1.2 years (interquartile range 0.9-1.5) at baseline. Mean ± SD baseline SLICC-FI was 0.17 ± 0.08. During mean ± SD follow-up of 7.2 ± 3.7 years, 614 patients (39.6%) experienced 1,570 hospitalizations. Higher baseline SLICC-FI values (per 0.05 increment) were associated with more frequent hospitalizations during follow-up, with an incidence rate ratio of 1.21 (95% confidence interval [95% CI] 1.13-1.30) after adjustment for baseline age, sex, glucocorticoid use, immunosuppressive use, ethnicity/location, SLE Disease Activity Index 2000 score, SLICC/American College of Rheumatology Damage Index score, and disease duration. Among patients with ≥1 hospitalization, higher baseline SLICC-FI values predicted a greater proportion of follow-up time spent hospitalized (relative rate 1.09 [95% CI 1.02-1.16]). CONCLUSION: The SLICC-FI predicts future hospitalizations among incident SLE patients, further supporting the SLICC-FI as a valid health measure in SLE.
OBJECTIVE: The Systemic Lupus International Collaborating Clinics (SLICC) frailty index (FI) predicts mortality and damage accrual in systemic lupus erythematosus (SLE), but its association with hospitalizations has not been described. Our objective was to estimate the association of baseline SLICC-FI values with future hospitalizations in the SLICC inception cohort. METHODS: Baseline SLICC-FI scores were calculated. The number and duration of inpatient hospitalizations during follow-up were recorded. Negative binomial regression was used to estimate the association between baseline SLICC-FI values and the rate of hospitalizations per patient-year of follow-up. Linear regression was used to estimate the association of baseline SLICC-FI scores with the proportion of follow-up time spent in the hospital. Multivariable models were adjusted for relevant baseline characteristics. RESULTS: The 1,549 patients with SLE eligible for this analysis were mostly female (88.7%), with a mean ± SD age of 35.7 ± 13.3 years and a median disease duration of 1.2 years (interquartile range 0.9-1.5) at baseline. Mean ± SD baseline SLICC-FI was 0.17 ± 0.08. During mean ± SD follow-up of 7.2 ± 3.7 years, 614 patients (39.6%) experienced 1,570 hospitalizations. Higher baseline SLICC-FI values (per 0.05 increment) were associated with more frequent hospitalizations during follow-up, with an incidence rate ratio of 1.21 (95% confidence interval [95% CI] 1.13-1.30) after adjustment for baseline age, sex, glucocorticoid use, immunosuppressive use, ethnicity/location, SLE Disease Activity Index 2000 score, SLICC/American College of Rheumatology Damage Index score, and disease duration. Among patients with ≥1 hospitalization, higher baseline SLICC-FI values predicted a greater proportion of follow-up time spent hospitalized (relative rate 1.09 [95% CI 1.02-1.16]). CONCLUSION: The SLICC-FI predicts future hospitalizations among incident SLE patients, further supporting the SLICC-FI as a valid health measure in SLE.
Authors: Angelica Nangit; Connie Lin; Mariko L Ishimori; Brennan M R Spiegel; Michael H Weisman Journal: J Rheumatol Date: 2018-04-15 Impact factor: 4.666
Authors: Kirsten K Ness; Gregory T Armstrong; Mondira Kundu; Carmen L Wilson; Tamara Tchkonia; James L Kirkland Journal: Cancer Date: 2014-12-19 Impact factor: 6.860
Authors: Thomas D Brothers; Susan Kirkland; Giovanni Guaraldi; Julian Falutz; Olga Theou; B Lynn Johnston; Kenneth Rockwood Journal: J Infect Dis Date: 2014-06-05 Impact factor: 5.226
Authors: Alexandra Legge; Susan Kirkland; Kenneth Rockwood; Pantelis Andreou; Sang-Cheol Bae; Caroline Gordon; Juanita Romero-Diaz; Jorge Sanchez-Guerrero; Daniel J Wallace; Sasha Bernatsky; Ann E Clarke; Joan T Merrill; Ellen M Ginzler; Paul Fortin; Dafna D Gladman; Murray B Urowitz; Ian N Bruce; David A Isenberg; Anisur Rahman; Graciela S Alarcón; Michelle Petri; Munther A Khamashta; M A Dooley; Rosalind Ramsey-Goldman; Susan Manzi; Asad A Zoma; Cynthia Aranow; Meggan Mackay; Guillermo Ruiz-Irastorza; S Sam Lim; Murat Inanc; Ronald F van Vollenhoven; Andreas Jonsen; Ola Nived; Manuel Ramos-Casals; Diane L Kamen; Kenneth C Kalunian; Soren Jacobsen; Christine A Peschken; Anca Askanase; John G Hanly Journal: J Rheumatol Date: 2019-04-15 Impact factor: 4.666
Authors: Katherine A Slawsky; Ancilla W Fernandes; Lauren Fusfeld; Susan Manzi; Thomas F Goss Journal: Arthritis Care Res (Hoboken) Date: 2011-09 Impact factor: 4.794
Authors: J G Hanly; M B Urowitz; J Sanchez-Guerrero; S C Bae; C Gordon; D J Wallace; D Isenberg; G S Alarcón; A Clarke; S Bernatsky; J T Merrill; M Petri; M A Dooley; D Gladman; P R Fortin; K Steinsson; I Bruce; S Manzi; M Khamashta; A Zoma; C Aranow; E Ginzler; R Van Vollenhoven; J Font; G Sturfelt; O Nived; R Ramsey-Goldman; K Kalunian; J Douglas; K Thompson; V Farewell Journal: Arthritis Rheum Date: 2007-01
Authors: Samuel D Searle; Arnold Mitnitski; Evelyne A Gahbauer; Thomas M Gill; Kenneth Rockwood Journal: BMC Geriatr Date: 2008-09-30 Impact factor: 3.921
Authors: Kaitlin Lima; Alexandra Legge; John G Hanly; Jungwha Lee; Jing Song; Anh Chung; Rosalind Ramsey-Goldman Journal: Arthritis Care Res (Hoboken) Date: 2021-09-30 Impact factor: 4.794