Hospital mortality in a cohort of Kyrgyz patients with systemic lupus erythematosus

High disease activity, major organ involvement, severe exacerbations, and infections are considered the most common causes of hospitalization in patients with systemic lupus erythematosus (SLE). Hospital mortality (HM) is higher among Asian, African, and Latin American patients compared with Caucasians. In Asian cohorts, the most frequent causes of HM are infections, severe lupus nephritis (LN), and neuropsychiatric manifestations.
Objective. To analyze the structure of mortality and prognostic factors associated with increased risk of death in hospitalized SLE patients.
Material and methods. The study included 800 patients with a confirmed diagnosis of SLE treated at the National Center of Cardiology and Therapy named after academician Mirsaid Mirrahimov from January 2012 to December 2024. An electronic database of fatal cases was used to assess the structure and causes of HM. For comparative analysis of clinical and laboratory manifestations of SLE and to identify predictors of HM, patients were divided into survivor and non-survivor groups. All patients underwent standard clinical, laboratory, and instrumental examinations.
Results and discussion. In the Kyrgyz SLE population, HM reached 3.3%. The vast majority of deceased patients were young women (88.5%) with acute disease course (53.9%), high activity (73.1%), kidney involvement (76.9%), central nervous system (CNS) involvement (50%), and lung involvement (34.6%). The main causes of HM were severe LN (30.8%) and combined kidney and CNS involvement (15.4%). Independent predictors of HM were LN with advanced chronic kidney disease (CKD), irreversible organ damage, and C3 hypocomplementemia.
Conclusion. The main causes of HM were severe LN (30.8%) and combined kidney and CNS involvement (15.4%). Independent predictors of HM included LN with advanced CKD, irreversible organ damage, and C3 hypocomplementemia.

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