Causes of hospitalization in systemic lupus erythematosus patients at a tertiary care center: insights from South Asia.

Introduction: Patients with systemic lupus erythematosus (SLE) often require hospitalization due to disease flares, infections, or other complications. While studies from high-income countries consistently report flares and infections as leading causes, data from South Asia remain limited. This study aimed to identify the leading causes of hospitalization and describe the associated clinical outcomes of patients admitted to a tertiary care center in Nepal. Methods: A descriptive cross-sectional study was conducted at the B.P. Koirala Institute of Health Sciences, Nepal, including all eligible SLE patients (aged >16 years and diagnosed for >3 months using the SLICC 2012 criteria) from November 2023 to November 2024. Demographic, clinical, laboratory, and treatment data were collected. Reasons for hospitalization and in-hospital outcomes were recorded. Data were analyzed using descriptive statistics. Results: Sixty-four patients were included; 93.8% were female, with a mean age of 32.4 ± 11.1 years. SLE flare was the most common cause of hospitalization (56.3%), followed by infection (20.3%). Renal flare accounted for the most flare-related admissions (39.1%), while urinary tract infection and acute undifferentiated fever were the leading infections. Nearly half of the patients (46.9%) were not on any immunosuppressive therapy at admission, and hydroxychloroquine use was suboptimal (67.2%). The mean hospital stay was 5.3 ± 3.0 days. Most patients were discharged in stable condition (95.3%); one required ICU transfer, and one died (1.6%). Conclusions: Renal flares and infections were the most frequent causes of hospitalization in this South Asian SLE cohort, highlighting the need for early recognition and management.