Risk factors for serious infections in inpatients with systemic lupus erythematosus.

Objectives: To investigate the risk factors for serious infections among hospitalized systemic lupus erythematosus (SLE) patients, and to provide the advice for preventing serious infections in SLE patients.

Methods: Information of SLE patients hospitalized from March 2017 to February 2019 at the Department of Rheumatology and Immunology, Xiangya Hospital, Central South University was obtained. The patients were assigned into a serious infection group and a non-serious infection group. The risk factors for serious infections among SLE inpatients were identified by comparison between the 2 groups and multivariate logistic regression analysis.

Results: There were 463 SLE inpatients in total, and 144 were in the serious infection group and 319 in the non-serious infection group. Multivariate logistic regression analysis showed that age ≥54.50 years old (OR=4.958, <0.001), cardiovascular involvement (OR=6.287, <0.001), hematologic involvement (OR=2.643, =0.003), serum albumin <20 g/L (OR=2.340, =0.036), C-reaction protein (CRP)/erythrocyte sedimentation rate (ESR)≥0.12 (OR=2.430, =0.002), glucocorticoid dose ≥8.75 mg/d prednisone-equivalent (OR=2.465, =0.002), and the combined use of immunosuppressive agents (OR=2.847, =0.037) were the risk factors for serious infections in SLE inpatients.

Conclusions: SLE patients with older age, cardiovascular involvement, hematologic involvement, low serum albumin are prone to suffering serious infections. Increased CRP/ESR ratio indicates serious infections in SLE inpatients. High-dose glucocorticoid and the combined use of immunosuppressive agents can increase the risk of serious infections in SLE inpatients.