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

Abstract

IntroductionHospitalized patients with systemic autoimmune rheumatic diseases (SARDs) generate high impact in clinical terms. ObjectivesTo 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. MethodsWe 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. ResultsInformation 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. ConclusionsIn 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.