Indications of Hospitalization and Predictors of Outcome among Patients with Rheumatological Diseases Admitted to Mansoura Rheumatology and Immunology unit

Background correction: Systemic autoimmune rheumatological diseases (SARDs) constitute a category of disorders that can affect several organs. SARDs are persistent, incapacitating illness characterized by significant morbidity and mortalityrates. Patients with SARDs necessitate hospitalization more frequently than the general population. Aim: To determine the characteristics of patients hospitalized with SARDs at Mansoura University Hospital. Materials and methods: This cross-sectional study was carried out on patients with different SARDs. The collected data included patients’ sociodemographic data, autoimmune disease diagnoses, the onset and duration of the disease, rate of readmission, the main cause of admission, the main organ affected at time of admission, and treatment received during hospitalization. The study included 517 patients with different SARDs (437 females and 80 males). The mean age of studied patients was 35.4 ± 12.8 years. 84.5% of the studied patients were females. Most of studied patients (74.4%) had rural background. About 64.2% of patients were SLE and 35.8% had diseases other than SLE. The most frequently reported non- SLE diagnoses included RA (9.5%), Behcet’s disease (6.2%), dermatomyositis (3.3%), vasculitis (3.3%), scleroderma (2.7%), 1ryAPLS (2.5%), FMF (2.3%) and adult onset Still disease (1.2%). The main indication for hospitalization was significant disease activity (53.7%), followed by renal biopsy (11%), and acute kidney injury (8.7%). Renal and hematological activity were the most frequent at time of admission, representing 29.4% and 15.8% respectively. Corticosteroids were the cornerstone of in-hospital management (83%). They were administered to induce rapid remission and control of inflammation. Hydroxychloroquine (HQC) was widely administered as safe and effective immunomodulator (53.6%). Mortality rate was 9.3%, ICU admission was required in 13.7%, septic shock was the leading cause of death accounting for 59.9%. Predictors of mortality were pulmonary disease (p Conclusion: We found that SLE was the leading cause of hospital admission among patients with SARDs. Renal affection was the most prevalent, with high degree of morbidity and mortality. Our findings underscored the importance of early identification and risk stratification to improve hospitalization outcome.