(901) Vestibular Symptoms and Inpatient Outcomes in Systemic Lupus Erythematosus: A National Inpatient Analysis

Introduction: Systemic Lupus Erythematosus (SLE) can cause vestibular symptoms, but their significance during SLE-related hospitalizations is poorly defined. This study evaluated the prognosis of hospitalized patients with SLE and vestibular symptoms.

Methods: Patients with a primary or secondary SLE diagnosis were identified from the Nationwide Inpatient Sample (2012-2022). Vestibular symptoms were defined by ICD codes for dizziness/giddiness, unsteadiness, and abnormal gait. Survey-weighted regressions assessed associations with discharge disposition (routine/home health vs non-routine) and hospital length of stay (LOS). Hospitalizations with missing discharge data were excluded from analyses.

Results: Among 67,485 SLE hospitalizations (mean age 43.6 years; 89.5% female; 41.9% White), 860 (1.2%) had vestibular symptoms. Patients with vestibular symptoms were older (p < 0.001) and more likely to have Medicare (p < 0.001). They demonstrated a higher comorbidity burden, with increased arrhythmias and hypertension (p < 0.001), as well as coagulopathy, depression, and renal failure (p < 0.05). Vestibular symptoms were independently associated with 37% increased odds of non-routine discharge (95%CI 1.12–1.67; p< 0.01) and a 12% increase in LOS (95%CI 1.06–1.17; p< 0.001). They were also associated with older age (p < 0.001), and Hispanic race (p < 0.01). There was no significant association with mortality (p=0.15).

Conclusions: Among hospitalized patients with SLE, vestibular symptoms were associated with an increased inpatient burden, including prolonged hospitalization and greater post-discharge care needs. This suggests that screening for vestibular symptoms may help identify patients with SLE at risk for higher healthcare utilization during hospitalizations.