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Youth: High Health Care Use Prior to SLE Diagnosis

Arthritis Care Res; ePub 2017 Dec 1; Chang, et al

Youth with systemic lupus erythematosus (SLE) have high health care utilization throughout the year preceding SLE diagnosis, a recent study found. Examining variable diagnostic trajectories of youth presenting for acute care preceding SLE diagnosis, and increased attention to psychiatric morbidity may help improve care for youth with new-onset SLE. Using Clinformatics DataMart de-identified administrative data from 2000 to 2013, researchers identified 682 youth aged 10- to 24 years with new-onset SLE, and 1,364 age and sex-matched healthy controls. They compared the incidence of ambulatory, emergency, and inpatient visits 12 months before SLE diagnosis, and frequency of primary diagnoses, and examined subject characteristics associated with utilization preceding SLE diagnosis. They found:

  • Youth with SLE had significantly more visits in the year preceding diagnosis than controls across ambulatory, emergency, and inpatient settings.
  • The most frequent acute care diagnoses and median days to SLE diagnosis were: venous thromboembolism, thrombocytopenia, chest pain, fever, and acute kidney failure.
  • Having a psychiatric diagnosis prior to SLE diagnosis was strongly associated with increased utilization across all settings.


Chang JC, Mandell DS, Knight AM. High health care utilization preceding diagnosis of systemic lupus erythematosus in youth. [Published online ahead of print December 1, 2017]. Arthritis Care Res. doi:10.1002/acr.23485.

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