A study at the University of California in San Francisco (UCSF) concluded that patients with lupus have one of the highest hospital readmission rates. The data suggest that one in six lupus patients require hospital readmission within a month after being discharged. Dr. Jinoos Yazdany, lead researcher and associate professor of medicine at the UCSF, believes these figures can be reduced by improved discharge planning in hospitals and tackling inequalities in health care.
Lupus is a disease in which the immune system attacks healthy cells and tissues; causing damage to various body parts such as joints, skin, kidneys, heart, and lungs, among others.
The Dr. Yazdany said that researchers do not yet fully understand all the causes of this condition, nevertheless it has been concluded that lupus has a genetic component. Drugs that help suppress the mistaken responses of the immune system, caused by lupus, often have very serious side effects. This results in this hospital readmission rate, so high among patients with lupus.
For the study, Dr. Yazdany’s team analyzed hospital discharge records between 2008 and 2009 of approximately 32,000 lupus patients in more than 800 hospitals in the states of New York, Florida, Utah, California and Washington.
The reasons of initial hospitalization generally fell into three categories: the first, for related causes of the disease itself (inflammation or organ failure); the second, for other conditions such as diabetes or heart disease, which commonly coexist with lupus; and the last, for infections, because the drugs used in lupus patients to suppress the immune system attacks to the body, also reduce the ability to fight bacterial and viral infections.
Dr. Joan Merrill, Medical Director of the Lupus Foundation of America and Head of Research in Clinical Pharmacology at the Oklahoma Medical Research Foundation, explained that when a patient admitted to the hospital have severe manifestations of lupus, he or she will be given aggressive immunosuppressive drugs; increasing the risk of infection. That’s going to increase the probabilities of rehospitalization; and if the treatments do not work, there is a risk of organ failure, she said.
Three conditions were the most common causes of readmissions: low blood platelet count, kidney inflammation (called lupus nephritis) and inflammation of the lining of the organs (serositis).
Dr. Yazdany pointed out that an effective transition requires good care coordination between health providers at the hospital and patient’s outpatient doctors. Furthermore, it requires that patients know when their follow-up outpatient appointments are, what symptoms to worry about and whom to call if needed.
Via: Health Library