Right heart failure outcomes in systemic lupus erythematosus: Cardiovascular insights from a nationwide inpatient study

Abstract

Background

Patients with Systemic Lupus Erythematosus (SLE) face a higher risk of cardiovascular morbidity, but data on Right Heart Failure (RHF) in-hospital outcomes in the context of SLE remain limited. Using a nationwide hospitalization database, we assess the impact of SLE on cardiovascular outcomes in cases of RHF.

Methods

RHF cases were queried from the 2016-2019 National Inpatient Sample, comparing outcomes between those with vs. without SLE. Primary outcome included all-cause mortality while secondary outcomes included vasopressor use, acute kidney injury (AKI), mechanical ventilation use, hospital length of stay (LOS), and total hospitalization charges (THC). Multivariable and linear regression models adjusted for confounders including patient demographics and comorbidity burden.

Results

Of 5,569 RHF hospitalizations, 2% (111) involved SLE. SLE was associated with higher mortality (adjusted OR [aOR] 3.8, 95% CI 1.19–12.29), AKI (aOR 2.61, 95% CI 1.05–6.52), vasopressor use (aOR 8.11, 95% CI 2.20-29.8). No differences were observed regarding odds of mechanical ventilation use (aOR 1.39, 95% CI 0.35-5.5), mean LOS (7.3 vs 6.5 days, p = .436) or THC ($258,475 vs $86,910, p = .301) between both groups.

Conclusion

Among RHF hospitalizations SLE is associated with higher mortality and non-fatal adverse outcomes. Further studies are necessary to confirm these findings and to clarify mechanisms aimed at improving outcomes for SLE patients hospitalized with RHF.