Outcomes of Emergency Department Visits in People with Systemic Lupus Erythematosus

People with systemic lupus erythematosus (SLE) who visit the emergency department (ED) are more likely to be women, Black, ages 31-50, have a higher incidence of comorbidity, and insured under Medicare, compared to people without SLE. In a new study, infection and SLE/connective tissue disease (CTD) were the top diagnoses associated with SLE ED visits and hospital admission. 

Researchers reviewed 414,139 records of ED visits for adults with SLE from the Nationwide Emergency Department Sample (NEDS) database. Records showed that around 20% of Black and Hispanic people with SLE who visited the ED were 18-30 years old and less than 10% of SLE visitors were White. Other findings: 

• Non-White people with SLE have higher Medicaid utilization (27%–32%) vs. White (19%)
• Black people with SLE exhibited chronic kidney disease, hypertension, and heart failure; and White people with SLE exhibited higher rates of hyperlipidemia (high levels of lipids or fats in the blood) and ischemic heart disease.
• SLE/CTD and infection were the most prevalent ED diagnosis in non-White and White people, respectively.
• Higher risk of admission was evident in people with SLE 65 years or older, are male, and had comorbidities.
• People with SLE who were Black or had low income were less likely to be admitted to the hospital. 

More research is needed to understand disparities in ED utilization, outcomes, and the role of different factors (such as disease activity and severity, reliance on the ED for routine care, and disparities in insurance coverage) to improve health equity and outcomes for all people with or without lupus. Learn more about living with lupus.

Read the study