title: Outcomes in hospitalized pediatric patients with systemic lupus erythematosus.
abstract: OBJECTIVE
  Disparities in outcomes among adults with systemic lupus erythematosus (SLE) have been documented. We investigated associations between sociodemographic factors and volume of annual inpatient hospital admissions with hospitalization characteristics and poor outcomes among patients with childhood-onset SLE.
  
  
  METHODS
  By using the Pediatric Health Information System, we analyzed admissions for patients aged 3 to <18 years at index admission with ≥ 1 International Classification of Diseases, Ninth Revision code for SLE from January 2006 to September 2011. Summary statistics and univariable analyses were used to examine demographic characteristics of hospital admissions, readmissions, and lengths of stay. We used multivariable logistic regression analyses, controlling for patient gender, age, race, ethnicity, insurance type, hospital volume, US census region, and severity of illness, to examine risk factors for poor outcomes.
  
  
  RESULTS
  A total of 10,724 admissions occurred among 2775 patients over the study period. Hispanic patients had longer lengths of stay, more readmissions, and higher in-hospital mortality. In multivariable analysis, African American race was significantly associated with ICU admission. African American race and Hispanic ethnicity were associated with end-stage renal disease and death. Volume of patients with SLE per hospital and hospital location were not significantly associated with outcomes.
  
  
  CONCLUSIONS
  In this cohort of hospitalized children with SLE, race and ethnicity were associated with outcomes. Further studies are needed to elucidate the relationship between sociodemographic factors and poor outcomes in patients with childhood-onset SLE.
authors.affiliation: Division of Immunology, Boston Children's Hospital, 300 Longwood Ave, Boston, MA 02115. marybeth.son@childrens.harvard.edu.
authors.forename: Mary Beth F
authors.initials: MB
authors.lastname: Son
authors.forename: Victor M
authors.initials: VM
authors.lastname: Johnson
authors.forename: Aimee O
authors.initials: AO
authors.lastname: Hersh
authors.forename: Mindy S
authors.initials: MS
authors.lastname: Lo
authors.forename: Karen H
authors.initials: KH
authors.lastname: Costenbader
mesh_terms: D000293:Adolescent; D001741:Black or African American; D002648:Child; D002675:Child, Preschool; D016208:Databases, Factual; D005260:Female; D005500:Follow-Up Studies; D054624:Health Status Disparities; D006630:Hispanic or Latino; D017052:Hospital Mortality; D006760:Hospitalization; D061847:Hospitals, High-Volume; D061846:Hospitals, Low-Volume; D006776:Hospitals, Pediatric; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D016015:Logistic Models; D008180:Lupus Erythematosus, Systemic / Q000208:ethnology / Q000401:mortality / Q000628:therapy*; D008297:Male; D015999:Multivariate Analysis; D010359:Patient Readmission / Q000706:statistics & numerical data; D012307:Risk Factors; D012720:Severity of Illness Index; D012959:Socioeconomic Factors; D016896:Treatment Outcome; D014481:United States
keywords: end-stage renal disease; mortality; outcomes; systemic lupus erythematosus