Hospital outcomes in patients evaluated by rheumatology in a Colombian historical cohort

Muñoz-Urbano, Marcela; Morales, Mónica Andrea; Arbeláez-Cortés, Álvaro

Introduction:

Hospitalized patients with systemic autoimmune rheumatic diseases (SARDs) generate high impact in clinical terms.

Objectives:

To characterize the study population and estimate risk factors associated with the presence of adverse outcomes in hospitalized patients consulting rheumatology at Clínica Imbanaco between January 2013 and December 2019.

Methods:

We analyzed a historical cohort of hospitalized patients who were evaluated by rheumatology. The population was classified as follows group 1, patients with new onset diagnosed SARDs; group 2, patients with known diagnosed SARDs; group 3, patients without diagnosed SARDs; and group 4, patients with unconfirmed suspicion of SARDs. A composite adverse outcome was defined if at least one of the following occurred (1) hospital mortality, (2) admission to the intensive care unit, (3) hospital infection, or (4) readmission.

Results:

Information was collected from 327 hospitalization events (307 patients). The median age was 48 (34-63) years and 222 (72.3%) were women. The composite adverse outcome occurred in 136 (41.5%) hospitalization events. Group 2 had the highest number of adverse outcomes (61/128; 47.6%). The variables associated with the worst outcomes were cardiovascular diagnosis at admission (OR = 4.63; CI 1.60-13.43; p = 0.005), longer hospital stay (OR = 1.04; CI 1.01-1.07; p = 0.005), and a treating specialty other than internal medicine (OR = 2.79; CI 1.26-6.17; p = 0.011). Male sex (OR = 0.29; CI 0.12-0.66; p = 0.004), having special health coverage (OR = 0.39; CI 0.15-.099; p = 0.047), and hemoglobin > 11.4 g/dL (OR = 0.82; CI 0.69-0.99; p = 0.039) were the factors associated with lower odds of developing the composite outcome.

Conclusions:

In this historical cohort, the group of patients with known diagnosed SARDs presented a higher number in percentage terms of adverse outcomes. The most frequent adverse outcomes were admission to the ICU and hospital readmission.

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