Sex-specific Outcomes of Acute Stroke in Patients with Systemic Lupus Erythematosus: A National Inpatient Sample Study

Tiberiu Pana* (Corresponding Author), Sona Jesenakova, Ben Carter, Rosemary Hollick, Mohamed O. Mohamed, Mamas A Mamas, Phyo Kyaw Myint

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Systemic lupus erythematosus (SLE) is an autoimmune disorder associated with increased stroke risk. Its association with stroke outcomes remains poorly understood. In this study, we aimed to compare the sex-specific SLE-associated acute stroke outcomes. Methods: Stroke hospitalisations between 2015 and 2018 from the National Inpatient Sample were analysed. The associations between SLE and outcomes (inpatient mortality, length-of-stay > 4 days and routine discharge) were examined using multivariable logistic regressions, stratifying by sex and adjusting for age, race, stroke type, revascularisation, hospital characteristics and comorbidities. Results: A total of 316,531 records representing 1,581,430 hospitalisations were included. Median (interquartile range) age was 71 (60–82) years. There were 940 (0.06%) males and 6110 (0.39%) females with SLE. There were no associations between SLE and mortality amongst either females (odds ratio (95% confidence interval) = 1.11 (0.84–1.48)) or males (0.81 (0.34–1.94)). Nevertheless, SLE was associated with prolonged hospitalisation (1.17 (1.03–1.32)) and lower odds of routine discharge (0.82 (0.72–0.94)) amongst females. There were no associations between SLE and other adverse outcomes amongst males. Conclusions: The association between SLE and acute stroke outcomes was influenced by sex. While SLE was not associated with mortality in either sex, females with SLE had higher odds of prolonged hospitalisation and lower odds of routine home discharge compared to patients without SLE, while males did not exhibit this increased risk.
Original languageEnglish
Article number462
Number of pages14
JournalJournal of Clinical Medicine
Volume12
Issue number2
Early online date6 Jan 2023
DOIs
Publication statusPublished - 2023

Keywords

  • stroke
  • Systemic lupus erythematosus
  • sex differences

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