Modelling Recurrent Events of Hospitalizations in Patients with Systemic Lupus Erythematosus (SLE)

Vaishali Halani; Manish Thaker

Volume : X, Issue : VIII, August - 2020

Modelling Recurrent Events of Hospitalizations in Patients with Systemic Lupus Erythematosus (SLE)

Vaishali Halani, Manish Thaker

Abstract :

Hospitalizations often occur multiple times during the disease course of a Systemic Lupus Erythematosus (SLE) patient. However, modelling of recurrent hospitalizations has not been fully explored. We investigated the association between patient factors and the risk of hospitalization among patients with SLE using an extension of the Cox model for the analysis of recurrent events such as Andersen and Gill [AG] model, Prentice, Williams and Peterson Total Time [PWP–TT] & Gap Time [PWP–GT] model. Over the follow–up of 1.5 years for 75 patients, more than 157 hospitalizations for which recurrence ranged from one to six were observed. The median follow–up time for the ﬁrst hospitalization event was 113 days and it increases for the consecutive recurrent events. The common reasons for recurrent hospitalization in SLE patients are SLE Flare (85.1%), Infection (10.3%) and Movement Disorder (4.6%). The importance of patient factors for the risk of being admitted to hospital was variable over the course of the disease. Conditions such as flare, infection and movement disorder had a sustained association with the rate of hospitalization across all episodes examined. The analysis of recurrent events can explore the longitudinal aspect of SLE and the critical issue of hospitalizations in this population. We recommend that the PWP models are better suited than the AG model for the analysis of risk factors for hospital admission among SLE patients. Overall, the most trusted model for this data is stratiﬁed gap–time model for this dataset.