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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Systemic lupus erythematosus &#40;SLE&#41; is a chronic autoimmune disease with a wide range of clinical and laboratory manifestations that has exacerbations and remissions&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;2</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Hospitalization is common&#44; with an estimated annual rate between 8&#46;6&#37; and 18&#46;9&#37;&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> The main reported reasons for admission are relapse of the disease and acute infection&#59; distinguishing between the two is a real diagnostic and therapeutic challenge&#46; While admissions due to SLE relapse vary between 15&#37; and 80&#46;8&#37;&#44; hospitalizations for infection range between 9&#46;4&#37; and 23&#46;2&#37; according to recent series&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#8211;8</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Other reported reasons are cardiovascular disease&#44; deep vein thrombosis &#40;DVT&#41; or pulmonary thromboembolism &#40;PTE&#41;&#44; associated autoimmune diseases&#44; pregnancy-related morbidity&#44; complications due to cumulative damage and adverse drug reactions&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Data on inpatients with SLE differ significantly across geographical regions&#44; probably due to ethnic&#44; social&#44; and economic factors&#44; among others&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> Even among populations in Latin America&#44; there are differences in the presentation of the disease&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">The aim of this study was to determine the reasons for the hospitalization of patients with SLE admitted to a university hospital in the city of Buenos Aires&#44; Argentina&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Materials and methods</span><p id="par0030" class="elsevierStylePara elsevierViewall">The clinical records of patients diagnosed with SLE and admitted to the Hospital de Cl&#237;nicas &#34;Jos&#233; de San Mart&#237;n&#34;&#44; in the city of Buenos Aires&#44; Argentina&#44; over a four-year period from January 2014 to December 2017&#44; were analysed retrospectively&#46; The criteria for inclusion were patients over 16 years old who met the criteria for SLE &#40;SLICC 2012&#41; during or before hospitalization&#46;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">11</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">The SLE Disease Activity Index 2000 &#40;SLEDAI-2&#8239;K&#41; was used to measure disease activity&#44; considering a patient to have active disease with a score equal to or greater than four&#46;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">12</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">Demographic data&#44; comorbid conditions&#44; reasons for hospitalization&#44; SLEDAI-2&#8239;K and treatment on admission were collected&#46; The reasons for hospitalization were not considered mutually exclusive&#44; therefore if a patient had more than one reason&#44; e&#46;g&#46; SLE relapse and infection&#44; both were recorded&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">Charlson&#39;s index was calculated to assess mortality at one year &#40;score 0&#44; 12&#37;&#59; 1&#8211;2&#44; 26&#37;&#59; 3&#8211;4&#44; 52&#37; and &#8805; 5&#44; 85&#37;&#41;&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">Epi Info v&#46; 7&#46;2 was used for the statistical analysis&#46; A descriptive analysis was conducted and percentages&#44; means &#40;SD&#41; and medians &#40;IQR&#41; were calculated&#46; Student and Mann-Whitney U tests were used to compare means and medians&#44; respectively&#44; in continuous variables&#46; Dichotomous variables were compared by means of a two-tailed Fisher test&#44; 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The duration of disease between SLE diagnosis and admission was a median of five years &#40;IQR 1&#8211;11&#59; range 0&#8722;35 years&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0065" class="elsevierStylePara elsevierViewall">The most frequent comorbidities were arterial hypertension &#40;ATH&#41; in 42 patients &#40;34&#46;7&#37;&#41;&#44; deep vein thrombosis &#40;DVT&#41; in 21 &#40;17&#46;3&#37;&#41;&#44; hypothyroidism in 19 &#40;5&#46;7&#37;&#41; and dyslipidaemia in 16 patients &#40;13&#46;2&#37;&#41;&#46; Of the patients with DVT only six &#40;28&#46;6&#37;&#41; had associated antiphospholipid syndrome &#40;APS&#41;&#46; In the cases of hypothyroidism&#44; eight &#40;42&#46;1&#37;&#41; were autoimmune&#46; Overlap with other autoimmune diseases was observed in 19&#37; of admissions&#44; mainly APS followed by systemic scleroderma&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">Of the total number of patients 10 &#40;8&#46;6&#37;&#41; were smokers&#44; 35 &#40;26&#37;&#41; ex-smokers&#44; 32 &#40;44&#46;4&#37;&#41; had been vaccinated against pneumococcus and 28 &#40;38&#46;8&#37;&#41; against influenza&#46; At the time of admission&#44; the median SLEDAI was five &#40;Range 0&#8722;27&#41;&#46; A mean Charlson index of 1&#46;42 &#40;SD 0&#46;84&#41; was observed with a range of 1&#8211;4&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">Of the 121 hospitalizations&#44; more than one reason for hospitalization was recorded in 32&#44; making a total of 164 reasons for admission&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a> shows the reasons for hospitalization of patients with SLE&#46; The main reason was relapse of disease 86&#47;164 reasons &#40;52&#46;4&#37;&#41;&#44; the most common being renal involvement 30&#47;86 &#40;34&#46;8&#37;&#41;&#44; serositis 10&#47;86 &#40;11&#46;6&#37;&#41; and pulmonary involvement 9&#47;86 &#40;10&#46;4&#37;&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0085" class="elsevierStylePara elsevierViewall">Infections were the second most common reason for hospitalization&#44; 44&#47;164 &#40;26&#46;8&#37;&#41;&#44; the most frequent being urinary tract infections 12&#47;44 &#40;27&#46;3&#37;&#41;&#44; pneumonia 11&#47;44 &#40;25&#37;&#41; and soft-tissue infections 6&#47;44 &#40;13&#46;6&#37;&#41;&#46; In patients who developed pneumonia&#44; no significant differences were found between patients vaccinated and unvaccinated for pneumococcus and influenza &#40;p&#8239;&#60;&#8239;&#46;52 and p&#8239;&#60;&#8239;1&#44; respectively&#41;&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">Hospitalization for cardiovascular reasons was observed in 6&#47;164 &#40;4&#46;96&#37;&#41;&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">Other reasons were found in 28&#47;164 &#40;17&#37;&#41;&#44; such as obstetric in 5&#47;28 &#40;17&#46;9&#37;&#41;&#44; drug injection in 4&#47;28 &#40;14&#46;3&#37;&#41;&#44; DVT&#47;PET in 4&#47;28 &#40;14&#46;3&#37;&#41;&#44; psychiatric in 2&#47;28 &#40;7&#46;1&#37;&#41;&#44; vertebral fracture in 1&#47;28 &#40;3&#46;6&#37;&#41;&#44; among others&#46; Of the hospital admissions for DVT&#47;PTE&#44; three had associated PAS&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">In the hospitalizations due to relapse of the disease the mean age was 35 &#40;SD 13&#46;9&#41; years versus 44&#46;12 &#40;SD 17&#46;9&#41; in the rest &#40;p&#8239;&#60;&#8239;&#46;0017&#41; and the median disease duration was 3&#46;5 &#40;IQR 1-7&#41; versus 7 years &#40;IQR 1-14&#59; p&#8239;&#60;&#8239;&#46;0017&#41;&#44; respectively&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">The SLEDAI-2&#8239;K score for relapse revealed a median of 10&#46;4 &#40;IQR 4&#8211;16&#41; while the remaining causes were 0 &#40;IQR 0&#8211;5&#41; &#40;p&#8239;&#60;&#8239;&#46;01&#41;&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">In the hospitalizations due to relapse&#44; the length of hospitalization was 16&#46;52 days &#40;SD 15&#41; vs&#46; 11&#46;75 &#40;SD 8&#46;9&#41; days for the remaining reasons &#40;p&#8239;&#60;&#8239;&#46;03&#41;&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">Seventeen out of 121 hospitalizations &#40;14&#46;05&#37;&#41; required a closed unit &#40;coronary unit or intensive care&#41;&#46; In these cases&#44; the median length of hospitalization was 24 days &#40;IQR 14&#8211;30&#41; compared to 10 days &#40;IQR 5&#8211;15&#46;5&#41; in the main ward &#40;p&#8239;&#60;&#8239;0&#46;008&#41;&#46; There were no statistically significant differences in age&#44; disease duration&#44; causes of hospitalization&#44; Charlson index&#44; or SLEDAI among those who required a closed unit compared to those who did not&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">Three patients &#40;2&#46;48&#37;&#41; died&#46; Causes of death were sepsis without focus&#44; obstetric complications&#44; and cardiogenic shock&#46; No significant differences in Charlson index values were observed between the patients who died compared to those who survived&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Discussion</span><p id="par0125" class="elsevierStylePara elsevierViewall">In this study we describe the reasons for hospitalization of SLE patients admitted to our hospital over a period of four years &#40;2014&#8211;2017&#41;&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">The main cause of hospitalization was relapse of the disease &#40;52&#46;4&#37;&#41;&#44; coinciding with that reported in the specialised literature&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;2&#44;4&#44;5</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">7&#44;8</span></a> The admission rate for this reason varies widely&#44; from 15&#37; in the Danish cohort<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> to 80&#46;8&#37; in the Malaysian cohort&#44; <span class="elsevierStyleSup">8</span> which could be due not only to ethnic and socioeconomic differences&#44; but also to the medical criteria used for hospitalization&#46; As in other series&#44; patients admitted due to relapse were younger&#44; had a higher SLEDAI-2&#8239;K score and shorter duration of SLE&#44;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;4&#44;6&#44;7</span></a> which supports the data that suggest greater aggressiveness during the first five years of the disease&#46;<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">13</span></a></p><p id="par0135" class="elsevierStylePara elsevierViewall">The second most frequent reason was infection &#40;26&#46;8&#37;&#41;&#46; The hospitalization rate for this reason was higher than previously reported &#40;9&#46;4&#37;-23&#46;2&#37;&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#8211;8</span></a> Compared with data from Latin America&#44; the percentage was similar to the Honduran cohort &#40;26&#46;3&#37;&#41;&#44;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a> although significantly lower than that of Peru &#40;42&#46;6&#37;&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">15</span></a> This discrepancy could be partly attributed to the design of our study&#44; where all reasons for hospitalization were recorded and not just the main reason as in other studies&#44; which may have underestimated the actual percentage of admissions due to infections&#46; On the other hand&#44; patients with SLE are clearly vulnerable to infection both because of the nature of the disease and because of the immunosuppressive treatment prescribed for the management of clinical manifestations&#46; In turn&#44; infection may influence the activity of SLE&#44;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">16</span></a> hence the importance of an adequate balance between disease control and infection prevention&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">The most frequent infections were of the urinary tract &#40;27&#46;3&#37;&#41;&#44; followed by pneumonia &#40;25&#37;&#41; and soft tissue infections &#40;13&#46;6&#37;&#41;&#46; Previous studies&#44; however&#44; identified pneumonia as the main infectious reason for hospitalization&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;2&#44;4&#44;7</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRefs" href="#bib0070"><span class="elsevierStyleSup">14&#44;15&#44;17&#44;18</span></a> Although in our study a high percentage of patients had been vaccinated against pneumococcus and influenza&#44; no significant differences were observed between vaccinated and unvaccinated patients with respect to the development of pneumonia&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">Cardiovascular involvement was responsible for 4&#46;9&#37; of hospitalizations&#46; Although patients with SLE have an increased risk of coronary disease compared to the general population&#44; resulting in high morbidity and mortality&#44; this was an infrequent reason for hospitalization in our series&#44; coinciding with previous studies&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;2&#44;4&#44;5</span></a> This could be due to the shorter disease duration at time of admission and the shorter cumulative time of corticosteroid use&#46;</p><p id="par0150" class="elsevierStylePara elsevierViewall">Thrombotic events were only observed in five cases &#40;four DVT&#47;PTE and one catastrophic APS&#41;&#44; similar to that reported in other studies&#46;<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3&#8211;5&#44;7</span></a> It should be noted that most patients had a history of APS&#44; being in an inadequate range of anticoagulation at the time of admission&#46;</p><p id="par0155" class="elsevierStylePara elsevierViewall">The percentage of patients with SLE requiring hospitalization in a closed unit &#40;coronary unit or intensive care&#41; was 14&#46;05&#37;&#44; similar to that reported in Canadian series that ranged from 13&#37; to 14&#46;3&#37;&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;6</span></a> However&#44; this result was higher than that described in other studies&#44; which present an average of 3&#46;9&#37; to 4&#46;8&#37;&#44;<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">7&#44;8</span></a> which could be attributed to a more severe clinical picture in our patients at the time of admission or during hospitalization&#44; observing significant differences in the median length of hospitalization among those requiring closed unit with respect to patients admitted to the main ward &#40;24 vs 10 days&#41;&#46;</p><p id="par0160" class="elsevierStylePara elsevierViewall">A total of 34&#46;7&#37; patients required re-hospitalization during the study period&#46; Previous reports showed variable results&#44; from 28&#46;7&#37; to 54&#46;7&#37;&#46;<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4&#8211;8</span></a> A recent study showed that 34&#37; of patients with SLE required readmission within 30 days of initial hospitalization&#44; observing a significant association with the presence of chronic damage&#44; anaemia and hypoalbuminaemia&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">19</span></a> Moreover&#44; an association with specific clinical manifestations such as nephritis&#44; serositis&#44; neurological involvement and thrombocytopenia was found&#44; while age had a significant inverse relationship with the risk of early readmission&#44; demonstrating once again the increased severity of SLE in young patients&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">20</span></a></p><p id="par0165" class="elsevierStylePara elsevierViewall">Mortality in hospitalized SLE patients varies from 2&#46;17&#37; to 10&#46;4&#37; depending on the series&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;2&#44;4&#44;6&#8211;8&#44;14&#44;15&#44;17</span></a> The main reasons reported are infection and relapse of the disease&#44;<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2&#44;4&#44;7&#44;8</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">17</span></a> relapse with concomitant infection and high rate of damage on admission being independent predictors of mortality&#46;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">15</span></a> In our study&#44; mortality was 2&#46;48&#37;&#44; the causes being sepsis without focus&#44; obstetric complication and cardiogenic shock&#46;</p><p id="par0170" class="elsevierStylePara elsevierViewall">Our work has some limitations&#58; its retrospective nature&#44; the number of patients included and a single hospital centre&#44; which could cause bias in interpretation&#46; On the other hand&#44; it is the first paper that describes reasons for hospitalization in lupus patients in Argentina&#44; contributing towards defining the characteristics of patients in our country and Latin America&#46;</p><p id="par0175" class="elsevierStylePara elsevierViewall">In conclusion&#44; patients with SLE are frequently admitted to our hospital&#44; the main reasons for hospitalization being relapse of the disease and infections&#46; This confirms that reported in the specialist literature&#46; However&#44; as in other Latin American countries such as Honduras and Peru&#44; the percentage of admissions due to infection was higher than that observed in other series&#44; which could be attributed to a greater susceptibility of our patients to infections&#44; either due to the treatment used to control SLE&#44; their own demographic characteristics or due to the functioning of the health system and access to it&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Funding</span><p id="par0180" class="elsevierStylePara elsevierViewall">This research has not received specific support from public sector agencies&#44; the commercial sector&#44; or non-profit organisations&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Conflict of interests</span><p id="par0185" class="elsevierStylePara elsevierViewall">The authors have no conflict of interests to declare&#46;</p></span></span>"
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    "fechaRecibido" => "2019-12-08"
    "fechaAceptado" => "2020-04-22"
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          "clase" => "keyword"
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          "palabras" => array:3 [
            0 => "Reasons for hospitalisation"
            1 => "Systemic lupus erythematosus"
            2 => "Hospitalization"
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          "clase" => "keyword"
          "titulo" => "Palabras clave"
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          "palabras" => array:3 [
            0 => "Causas internaci&#243;n"
            1 => "Lupus eritematoso sist&#233;mico"
            2 => "Hospitalizaci&#243;n"
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        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objective</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">To determine the reasons for hospitalisation in patients with systemic lupus erythematosus &#40;SLE&#41; admitted to the Hospital de Cl&#237;nicas &#34;Jos&#233; de San Mart&#237;n&#34; Buenos Aires&#44; Argentina&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Methods</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">We retrospectively analysed the clinical histories of SLE patients &#40;SLICC 2012&#41; during or prior to hospitalisation&#44; from 1-2014 to 12-2017&#46; Demographic data&#44; reasons for hospitalisation&#44; treatments&#44; SLEDAI-2&#8239;K and comorbid conditions&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">121 hospitalisations corresponding to 72 patients&#44; 25 patients &#40;34&#46;7&#37;&#41; were hospitalised more than once&#46; Females &#40;83&#46;3&#37;&#41;&#44; the median length of disease until admission was 5 years&#46; There was more than one reason for hospitalisation in 32&#44; a total of 164 reasons&#46; The main reason was relapse of disease &#40;52&#46;4&#37;&#41;&#46; The most frequent manifestations were renal involvement&#44; serositis and pulmonary involvement&#46; Infections were the second reason for hospitalisation &#40;26&#46;8&#37;&#41;&#59; urinary tract&#44; pneumonia and soft tissue&#46; Cardiovascular involvement 4&#46;9&#37;&#46; Hospitalisation in a closed unit 14&#46;05&#37;&#44; mortality 2&#46;48&#37;&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusion</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Relapse of disease and infections were the main reasons for hospitalisation&#59; admission secondary to infection was higher than that reported in other series&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0005"
            "titulo" => "Objective"
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          1 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "Methods"
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        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Objetivo</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Determinar causas de hospitalizaci&#243;n en pacientes con lupus eritematoso sist&#233;mico &#40;LES&#41; internados en Hospital de Cl&#237;nicas &#8220;Jos&#233; de San Mart&#237;n&#8221; Buenos Aires&#44; Argentina&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">M&#233;todos</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Se analizaron retrospectivamente historias cl&#237;nicas de pacientes LES &#40;SLICC 2012&#41; durante o previo a la internaci&#243;n&#44; desde 1-2014 hasta 12-2017&#46; Datos demogr&#225;ficos&#44; motivos de hospitalizaci&#243;n&#44; tratamientos&#44; SLEDAI 2&#8239;K y condiciones com&#243;rbidas&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">121 hospitalizaciones correspondientes a 72 pacientes&#44; 25 pacientes &#40;34&#44;7&#37;&#41; tuvieron m&#225;s de una hospitalizaci&#243;n&#46; Mujeres &#40;83&#44;3&#37;&#41;&#44; mediana de duraci&#243;n de la enfermedad hasta la admisi&#243;n 5 a&#241;os&#46; M&#225;s de una causa de internaci&#243;n en 32&#44; total de 164 motivos&#46; La principal causa fue reca&#237;da de la enfermedad &#40;52&#44;4&#37;&#41;&#46; La manifestaci&#243;n m&#225;s frecuente fue compromiso renal&#44; serositis y compromiso pulmonar&#46; Las infecciones fueron la segunda causa de hospitalizaci&#243;n &#40;26&#44;8&#37;&#41;&#59; tracto urinario&#44; neumon&#237;a y partes blandas&#46; Compromiso cardiovascular 4&#44;9&#37;&#46; Hospitalizaci&#243;n en unidad cerrada 14&#44;05&#37;&#44; mortalidad 2&#44;48&#37;&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusi&#243;n</span><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Reca&#237;da de la enfermedad e infecciones&#44; fueron las principales causas de hospitalizaci&#243;n&#59; la admisi&#243;n secundaria a infecci&#243;n fue superior a la reportada en otras series&#46;</p></span>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Perrotta N&#44; L&#243;pez Meiller MJ&#44; Malah V&#44; Dubinsky D&#46; Causas de internaci&#243;n en pacientes con lupus eritematoso sist&#233;mico en un hospital universitario de Buenos Aires&#46; Reumatol Clin&#46; 2021&#59;17&#58;471&#8211;474&#46;</p>"
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">60 &#40;83&#46;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Age &#40;mean&#8239;&#177;&#8239;SD&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">40 &#40;&#177; 16&#46;43&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Disease duration in years &#40;range&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5 &#40;0&#8722;35&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Corticosteroids&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">91&#47;121&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Corticosteroids &#62; 10&#8239;mg&#47;d&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">27&#47;121&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Median SLEDAI &#40;range&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5 &#40;0&#8722;27&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Activity mean &#40;SLEDAI&#8239;&#62;&#8239;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">31&#47;121&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">High activity &#40;SLEDAI&#8239;&#62;&#8239;10&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">37&#47;121&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Very high activity &#40;SLEDAI&#8239;&#62;&#8239;19&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&#47;121&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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        "tabla" => array:2 [
          "leyenda" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">AOS&#58; Ascitic oedematous syndrome&#59; CA&#58; Cancer&#59; DVT&#47;PTE&#58; Deep vein thrombosis&#47;pulmonary thromboembolism&#59; FUO&#58; Fever of unknown origin&#59; HZ&#58; Herpes zoster&#59; LL&#58; Lower limb&#59; UTI&#58; Urinary tract infection&#46;</p>"
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              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Reasons for hospitalizationN&#58;164&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Relapse of disease&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">86 &#40;52&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Renal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">30 &#40;34&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Serositis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10 &#40;11&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Pulmonary&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9 &#40;10&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Articular&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;9&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Mucocutaneous&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;8&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Haematological&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;8&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Gastric&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6 &#40;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Neurological&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5 &#40;5&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Cardiac&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 &#40;4&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Infections&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">44 &#40;26&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">UTI&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12 &#40;27&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Pneumonia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11 &#40;25&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Skin and BP&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6 &#40;13&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Gynaecological&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;6&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Without focusBacteriaemia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;6&#46;8&#41;3 &#40;6&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">ProsthesisHZ&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;4&#46;6&#41;1 &#40;2&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Septic arthritis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;2&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">SyphilisAbdominal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;2&#46;3&#41;1 &#40;2&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Cardiovascular&#40;AMI&#44; valvopathies&#44; heart failure&#44; cardiogenic shock&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6 &#40;4&#46;96&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">OTHER&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">28 &#40;17&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Obstetric&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5 &#40;17&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Drug injection&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 &#40;14&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">DVT&#47;PTE&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 &#40;14&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Studies&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;7&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Psychiatric&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;7&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Vertebral fracture&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;3&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Catastrophic APS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;3&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Lupus cystitis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;3&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Lower back pain&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;3&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">FUO&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;3&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">LL oedema&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;3&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Muscle weakness&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;3&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Myasthenic crisis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;3&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">AOS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;3&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Lung CA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;3&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Epistaxis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;3&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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        "descripcion" => array:1 [
          "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Reasons for hospitalization&#46;</p>"
        ]
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      "titulo" => "References"
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        0 => array:2 [
          "identificador" => "bibs0005"
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            0 => array:3 [
              "identificador" => "bib0005"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "All cause hospitalizations in systemic lupus erythematosus from a large Canadian referral centre"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "J&#46; Lee"
                            1 => "N&#46; Dhillon"
                            2 => "J&#46; Pope"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/rheumatology/kes391"
                      "Revista" => array:6 [
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                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23307831"
                            "web" => "Medline"
                          ]
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "All-cause hospitalizations in systemic lupus erythematosus from a single medical center in Israel"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
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                            0 => "Ofer Levy"
                            1 => "Andrey Markov"
                            2 => "Yulia Drob"
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                            4 => "Moshe Tishler"
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                      "Revista" => array:6 [
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Hospitalizations among Danish SLE patients&#58; a prospective study on incidence&#44; causes of admission and risk factors in a population-based cohort"
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                            1 => "S&#46;D&#46; Kay"
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                          "etal" => true
                          "autores" => array:3 [
                            0 => "M&#46; -Jallouli"
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                            2 => "Y&#46; Cherif"
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                    0 => array:1 [
                      "Revista" => array:3 [
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                    0 => array:2 [
                      "titulo" => "The rate of and risk factors for frequent hospitalization in systemic lupus erythematosus&#58; Results from the Korean lupus network registry"
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                        0 => array:2 [
                          "etal" => true
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                            1 => "D&#46;J&#46; Park"
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                          "etal" => false
                          "autores" => array:4 [
                            0 => "K&#46; Gu"
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                            3 => "M&#46;B&#46; Urowitz"
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                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3899/jrheum.170072"
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                  "contribucion" => array:1 [
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                      "titulo" => "Causes and factors related to hospitalizations in patients with systemic lupus erythematosus&#58; analysis of a 20 year period &#40;1995-2015&#41; from a single referral centre in Catalonia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:4 [
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                            3 => "G&#46; Espinosa"
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                  "host" => array:1 [
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                      "titulo" => "Systemic lupus erythematosus in a tertiary&#44; east Malaysian hospital&#58; admission&#44; readmission and death"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "C&#46;L&#46; Teh"
                            1 => "G&#46;Y&#46;L&#46; Chan"
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                    ]
                  ]
                  "host" => array:1 [
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                            0 => "G&#46;R&#46;V&#46; Hughes"
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                      "titulo" => "Lupus in Latin-American patients&#58; Lessons from the GLADEL cohort"
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                          "etal" => true
                          "autores" => array:5 [
                            0 => "G&#46;J&#46; Pons-Estel"
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                            2 => "M&#46;H&#46; Cardiel"
                            3 => "E&#46; Bonfa"
                            4 => "F&#46; Caeiro"
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                        ]
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                    ]
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                    0 => array:2 [
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            10 => array:3 [
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Reasons for hospitalisation in patients with systemic lupus erythematosus in a university hospital in Buenos Aires
Causas de internación en pacientes con lupus eritematoso sistémico en un hospital universitario de Buenos Aires
Natalia Perrotta, María José López Meiller
Corresponding author
majocontact@gmail.com

Corresponding author.
, Verónica Malah, Diana Dubinsky
Hospital de Clínicas José de San Martín, Buenos Aires, Argentina
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    "titulo" => "Reasons for hospitalisation in patients with systemic lupus erythematosus in a university hospital in Buenos Aires"
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Systemic lupus erythematosus &#40;SLE&#41; is a chronic autoimmune disease with a wide range of clinical and laboratory manifestations that has exacerbations and remissions&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;2</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Hospitalization is common&#44; with an estimated annual rate between 8&#46;6&#37; and 18&#46;9&#37;&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> The main reported reasons for admission are relapse of the disease and acute infection&#59; distinguishing between the two is a real diagnostic and therapeutic challenge&#46; While admissions due to SLE relapse vary between 15&#37; and 80&#46;8&#37;&#44; hospitalizations for infection range between 9&#46;4&#37; and 23&#46;2&#37; according to recent series&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#8211;8</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Other reported reasons are cardiovascular disease&#44; deep vein thrombosis &#40;DVT&#41; or pulmonary thromboembolism &#40;PTE&#41;&#44; associated autoimmune diseases&#44; pregnancy-related morbidity&#44; complications due to cumulative damage and adverse drug reactions&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Data on inpatients with SLE differ significantly across geographical regions&#44; probably due to ethnic&#44; social&#44; and economic factors&#44; among others&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> Even among populations in Latin America&#44; there are differences in the presentation of the disease&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">The aim of this study was to determine the reasons for the hospitalization of patients with SLE admitted to a university hospital in the city of Buenos Aires&#44; Argentina&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Materials and methods</span><p id="par0030" class="elsevierStylePara elsevierViewall">The clinical records of patients diagnosed with SLE and admitted to the Hospital de Cl&#237;nicas &#34;Jos&#233; de San Mart&#237;n&#34;&#44; in the city of Buenos Aires&#44; Argentina&#44; over a four-year period from January 2014 to December 2017&#44; were analysed retrospectively&#46; The criteria for inclusion were patients over 16 years old who met the criteria for SLE &#40;SLICC 2012&#41; during or before hospitalization&#46;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">11</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">The SLE Disease Activity Index 2000 &#40;SLEDAI-2&#8239;K&#41; was used to measure disease activity&#44; considering a patient to have active disease with a score equal to or greater than four&#46;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">12</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">Demographic data&#44; comorbid conditions&#44; reasons for hospitalization&#44; SLEDAI-2&#8239;K and treatment on admission were collected&#46; The reasons for hospitalization were not considered mutually exclusive&#44; therefore if a patient had more than one reason&#44; e&#46;g&#46; SLE relapse and infection&#44; both were recorded&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">Charlson&#39;s index was calculated to assess mortality at one year &#40;score 0&#44; 12&#37;&#59; 1&#8211;2&#44; 26&#37;&#59; 3&#8211;4&#44; 52&#37; and &#8805; 5&#44; 85&#37;&#41;&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">Epi Info v&#46; 7&#46;2 was used for the statistical analysis&#46; A descriptive analysis was conducted and percentages&#44; means &#40;SD&#41; and medians &#40;IQR&#41; were calculated&#46; Student and Mann-Whitney U tests were used to compare means and medians&#44; respectively&#44; in continuous variables&#46; Dichotomous variables were compared by means of a two-tailed Fisher test&#44; considering a p&#8239;&#60;&#8239;&#46;05 statistically significant&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Results</span><p id="par0055" class="elsevierStylePara elsevierViewall">Data from 121 hospitalizations corresponding to 72 patients with SLE were reviewed&#46; Nine patients &#40;9&#47;72 patients&#44; 12&#46;5&#37;&#41; were admitted for organic involvement that led to the diagnosis of SLE during hospitalization&#46; Twenty-five of the 72 patients &#40;34&#46;7&#37;&#41; had more than one hospitalization&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> shows the demographics&#44; medication&#44; and disease activity&#46; The majority were females &#40;60&#59; 83&#46;3&#37;&#41;&#44; with a female&#58; male ratio of 5&#58;1&#46; The median age at diagnosis was 26 years &#40;IQR 19&#8211;38&#41; and the mean age at admission was 40 years &#40;SD 16&#46;43&#41;&#46; The duration of disease between SLE diagnosis and admission was a median of five years &#40;IQR 1&#8211;11&#59; range 0&#8722;35 years&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0065" class="elsevierStylePara elsevierViewall">The most frequent comorbidities were arterial hypertension &#40;ATH&#41; in 42 patients &#40;34&#46;7&#37;&#41;&#44; deep vein thrombosis &#40;DVT&#41; in 21 &#40;17&#46;3&#37;&#41;&#44; hypothyroidism in 19 &#40;5&#46;7&#37;&#41; and dyslipidaemia in 16 patients &#40;13&#46;2&#37;&#41;&#46; Of the patients with DVT only six &#40;28&#46;6&#37;&#41; had associated antiphospholipid syndrome &#40;APS&#41;&#46; In the cases of hypothyroidism&#44; eight &#40;42&#46;1&#37;&#41; were autoimmune&#46; Overlap with other autoimmune diseases was observed in 19&#37; of admissions&#44; mainly APS followed by systemic scleroderma&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">Of the total number of patients 10 &#40;8&#46;6&#37;&#41; were smokers&#44; 35 &#40;26&#37;&#41; ex-smokers&#44; 32 &#40;44&#46;4&#37;&#41; had been vaccinated against pneumococcus and 28 &#40;38&#46;8&#37;&#41; against influenza&#46; At the time of admission&#44; the median SLEDAI was five &#40;Range 0&#8722;27&#41;&#46; A mean Charlson index of 1&#46;42 &#40;SD 0&#46;84&#41; was observed with a range of 1&#8211;4&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">Of the 121 hospitalizations&#44; more than one reason for hospitalization was recorded in 32&#44; making a total of 164 reasons for admission&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a> shows the reasons for hospitalization of patients with SLE&#46; The main reason was relapse of disease 86&#47;164 reasons &#40;52&#46;4&#37;&#41;&#44; the most common being renal involvement 30&#47;86 &#40;34&#46;8&#37;&#41;&#44; serositis 10&#47;86 &#40;11&#46;6&#37;&#41; and pulmonary involvement 9&#47;86 &#40;10&#46;4&#37;&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0085" class="elsevierStylePara elsevierViewall">Infections were the second most common reason for hospitalization&#44; 44&#47;164 &#40;26&#46;8&#37;&#41;&#44; the most frequent being urinary tract infections 12&#47;44 &#40;27&#46;3&#37;&#41;&#44; pneumonia 11&#47;44 &#40;25&#37;&#41; and soft-tissue infections 6&#47;44 &#40;13&#46;6&#37;&#41;&#46; In patients who developed pneumonia&#44; no significant differences were found between patients vaccinated and unvaccinated for pneumococcus and influenza &#40;p&#8239;&#60;&#8239;&#46;52 and p&#8239;&#60;&#8239;1&#44; respectively&#41;&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">Hospitalization for cardiovascular reasons was observed in 6&#47;164 &#40;4&#46;96&#37;&#41;&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">Other reasons were found in 28&#47;164 &#40;17&#37;&#41;&#44; such as obstetric in 5&#47;28 &#40;17&#46;9&#37;&#41;&#44; drug injection in 4&#47;28 &#40;14&#46;3&#37;&#41;&#44; DVT&#47;PET in 4&#47;28 &#40;14&#46;3&#37;&#41;&#44; psychiatric in 2&#47;28 &#40;7&#46;1&#37;&#41;&#44; vertebral fracture in 1&#47;28 &#40;3&#46;6&#37;&#41;&#44; among others&#46; Of the hospital admissions for DVT&#47;PTE&#44; three had associated PAS&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">In the hospitalizations due to relapse of the disease the mean age was 35 &#40;SD 13&#46;9&#41; years versus 44&#46;12 &#40;SD 17&#46;9&#41; in the rest &#40;p&#8239;&#60;&#8239;&#46;0017&#41; and the median disease duration was 3&#46;5 &#40;IQR 1-7&#41; versus 7 years &#40;IQR 1-14&#59; p&#8239;&#60;&#8239;&#46;0017&#41;&#44; respectively&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">The SLEDAI-2&#8239;K score for relapse revealed a median of 10&#46;4 &#40;IQR 4&#8211;16&#41; while the remaining causes were 0 &#40;IQR 0&#8211;5&#41; &#40;p&#8239;&#60;&#8239;&#46;01&#41;&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">In the hospitalizations due to relapse&#44; the length of hospitalization was 16&#46;52 days &#40;SD 15&#41; vs&#46; 11&#46;75 &#40;SD 8&#46;9&#41; days for the remaining reasons &#40;p&#8239;&#60;&#8239;&#46;03&#41;&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">Seventeen out of 121 hospitalizations &#40;14&#46;05&#37;&#41; required a closed unit &#40;coronary unit or intensive care&#41;&#46; In these cases&#44; the median length of hospitalization was 24 days &#40;IQR 14&#8211;30&#41; compared to 10 days &#40;IQR 5&#8211;15&#46;5&#41; in the main ward &#40;p&#8239;&#60;&#8239;0&#46;008&#41;&#46; There were no statistically significant differences in age&#44; disease duration&#44; causes of hospitalization&#44; Charlson index&#44; or SLEDAI among those who required a closed unit compared to those who did not&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">Three patients &#40;2&#46;48&#37;&#41; died&#46; Causes of death were sepsis without focus&#44; obstetric complications&#44; and cardiogenic shock&#46; No significant differences in Charlson index values were observed between the patients who died compared to those who survived&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Discussion</span><p id="par0125" class="elsevierStylePara elsevierViewall">In this study we describe the reasons for hospitalization of SLE patients admitted to our hospital over a period of four years &#40;2014&#8211;2017&#41;&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">The main cause of hospitalization was relapse of the disease &#40;52&#46;4&#37;&#41;&#44; coinciding with that reported in the specialised literature&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;2&#44;4&#44;5</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">7&#44;8</span></a> The admission rate for this reason varies widely&#44; from 15&#37; in the Danish cohort<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> to 80&#46;8&#37; in the Malaysian cohort&#44; <span class="elsevierStyleSup">8</span> which could be due not only to ethnic and socioeconomic differences&#44; but also to the medical criteria used for hospitalization&#46; As in other series&#44; patients admitted due to relapse were younger&#44; had a higher SLEDAI-2&#8239;K score and shorter duration of SLE&#44;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;4&#44;6&#44;7</span></a> which supports the data that suggest greater aggressiveness during the first five years of the disease&#46;<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">13</span></a></p><p id="par0135" class="elsevierStylePara elsevierViewall">The second most frequent reason was infection &#40;26&#46;8&#37;&#41;&#46; The hospitalization rate for this reason was higher than previously reported &#40;9&#46;4&#37;-23&#46;2&#37;&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#8211;8</span></a> Compared with data from Latin America&#44; the percentage was similar to the Honduran cohort &#40;26&#46;3&#37;&#41;&#44;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a> although significantly lower than that of Peru &#40;42&#46;6&#37;&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">15</span></a> This discrepancy could be partly attributed to the design of our study&#44; where all reasons for hospitalization were recorded and not just the main reason as in other studies&#44; which may have underestimated the actual percentage of admissions due to infections&#46; On the other hand&#44; patients with SLE are clearly vulnerable to infection both because of the nature of the disease and because of the immunosuppressive treatment prescribed for the management of clinical manifestations&#46; In turn&#44; infection may influence the activity of SLE&#44;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">16</span></a> hence the importance of an adequate balance between disease control and infection prevention&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">The most frequent infections were of the urinary tract &#40;27&#46;3&#37;&#41;&#44; followed by pneumonia &#40;25&#37;&#41; and soft tissue infections &#40;13&#46;6&#37;&#41;&#46; Previous studies&#44; however&#44; identified pneumonia as the main infectious reason for hospitalization&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;2&#44;4&#44;7</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRefs" href="#bib0070"><span class="elsevierStyleSup">14&#44;15&#44;17&#44;18</span></a> Although in our study a high percentage of patients had been vaccinated against pneumococcus and influenza&#44; no significant differences were observed between vaccinated and unvaccinated patients with respect to the development of pneumonia&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">Cardiovascular involvement was responsible for 4&#46;9&#37; of hospitalizations&#46; Although patients with SLE have an increased risk of coronary disease compared to the general population&#44; resulting in high morbidity and mortality&#44; this was an infrequent reason for hospitalization in our series&#44; coinciding with previous studies&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;2&#44;4&#44;5</span></a> This could be due to the shorter disease duration at time of admission and the shorter cumulative time of corticosteroid use&#46;</p><p id="par0150" class="elsevierStylePara elsevierViewall">Thrombotic events were only observed in five cases &#40;four DVT&#47;PTE and one catastrophic APS&#41;&#44; similar to that reported in other studies&#46;<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3&#8211;5&#44;7</span></a> It should be noted that most patients had a history of APS&#44; being in an inadequate range of anticoagulation at the time of admission&#46;</p><p id="par0155" class="elsevierStylePara elsevierViewall">The percentage of patients with SLE requiring hospitalization in a closed unit &#40;coronary unit or intensive care&#41; was 14&#46;05&#37;&#44; similar to that reported in Canadian series that ranged from 13&#37; to 14&#46;3&#37;&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;6</span></a> However&#44; this result was higher than that described in other studies&#44; which present an average of 3&#46;9&#37; to 4&#46;8&#37;&#44;<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">7&#44;8</span></a> which could be attributed to a more severe clinical picture in our patients at the time of admission or during hospitalization&#44; observing significant differences in the median length of hospitalization among those requiring closed unit with respect to patients admitted to the main ward &#40;24 vs 10 days&#41;&#46;</p><p id="par0160" class="elsevierStylePara elsevierViewall">A total of 34&#46;7&#37; patients required re-hospitalization during the study period&#46; Previous reports showed variable results&#44; from 28&#46;7&#37; to 54&#46;7&#37;&#46;<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4&#8211;8</span></a> A recent study showed that 34&#37; of patients with SLE required readmission within 30 days of initial hospitalization&#44; observing a significant association with the presence of chronic damage&#44; anaemia and hypoalbuminaemia&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">19</span></a> Moreover&#44; an association with specific clinical manifestations such as nephritis&#44; serositis&#44; neurological involvement and thrombocytopenia was found&#44; while age had a significant inverse relationship with the risk of early readmission&#44; demonstrating once again the increased severity of SLE in young patients&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">20</span></a></p><p id="par0165" class="elsevierStylePara elsevierViewall">Mortality in hospitalized SLE patients varies from 2&#46;17&#37; to 10&#46;4&#37; depending on the series&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;2&#44;4&#44;6&#8211;8&#44;14&#44;15&#44;17</span></a> The main reasons reported are infection and relapse of the disease&#44;<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2&#44;4&#44;7&#44;8</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">17</span></a> relapse with concomitant infection and high rate of damage on admission being independent predictors of mortality&#46;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">15</span></a> In our study&#44; mortality was 2&#46;48&#37;&#44; the causes being sepsis without focus&#44; obstetric complication and cardiogenic shock&#46;</p><p id="par0170" class="elsevierStylePara elsevierViewall">Our work has some limitations&#58; its retrospective nature&#44; the number of patients included and a single hospital centre&#44; which could cause bias in interpretation&#46; On the other hand&#44; it is the first paper that describes reasons for hospitalization in lupus patients in Argentina&#44; contributing towards defining the characteristics of patients in our country and Latin America&#46;</p><p id="par0175" class="elsevierStylePara elsevierViewall">In conclusion&#44; patients with SLE are frequently admitted to our hospital&#44; the main reasons for hospitalization being relapse of the disease and infections&#46; This confirms that reported in the specialist literature&#46; However&#44; as in other Latin American countries such as Honduras and Peru&#44; the percentage of admissions due to infection was higher than that observed in other series&#44; which could be attributed to a greater susceptibility of our patients to infections&#44; either due to the treatment used to control SLE&#44; their own demographic characteristics or due to the functioning of the health system and access to it&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Funding</span><p id="par0180" class="elsevierStylePara elsevierViewall">This research has not received specific support from public sector agencies&#44; the commercial sector&#44; or non-profit organisations&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Conflict of interests</span><p id="par0185" class="elsevierStylePara elsevierViewall">The authors have no conflict of interests to declare&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
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              "titulo" => "Resultados"
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              "titulo" => "Conclusi&#243;n"
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          "titulo" => "Palabras clave"
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          "titulo" => "Introduction"
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          "titulo" => "References"
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    "tienePdf" => true
    "fechaRecibido" => "2019-12-08"
    "fechaAceptado" => "2020-04-22"
    "PalabrasClave" => array:2 [
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec1425615"
          "palabras" => array:3 [
            0 => "Reasons for hospitalisation"
            1 => "Systemic lupus erythematosus"
            2 => "Hospitalization"
          ]
        ]
      ]
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        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
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          "palabras" => array:3 [
            0 => "Causas internaci&#243;n"
            1 => "Lupus eritematoso sist&#233;mico"
            2 => "Hospitalizaci&#243;n"
          ]
        ]
      ]
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      "en" => array:3 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objective</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">To determine the reasons for hospitalisation in patients with systemic lupus erythematosus &#40;SLE&#41; admitted to the Hospital de Cl&#237;nicas &#34;Jos&#233; de San Mart&#237;n&#34; Buenos Aires&#44; Argentina&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Methods</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">We retrospectively analysed the clinical histories of SLE patients &#40;SLICC 2012&#41; during or prior to hospitalisation&#44; from 1-2014 to 12-2017&#46; Demographic data&#44; reasons for hospitalisation&#44; treatments&#44; SLEDAI-2&#8239;K and comorbid conditions&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">121 hospitalisations corresponding to 72 patients&#44; 25 patients &#40;34&#46;7&#37;&#41; were hospitalised more than once&#46; Females &#40;83&#46;3&#37;&#41;&#44; the median length of disease until admission was 5 years&#46; There was more than one reason for hospitalisation in 32&#44; a total of 164 reasons&#46; The main reason was relapse of disease &#40;52&#46;4&#37;&#41;&#46; The most frequent manifestations were renal involvement&#44; serositis and pulmonary involvement&#46; Infections were the second reason for hospitalisation &#40;26&#46;8&#37;&#41;&#59; urinary tract&#44; pneumonia and soft tissue&#46; Cardiovascular involvement 4&#46;9&#37;&#46; Hospitalisation in a closed unit 14&#46;05&#37;&#44; mortality 2&#46;48&#37;&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusion</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Relapse of disease and infections were the main reasons for hospitalisation&#59; admission secondary to infection was higher than that reported in other series&#46;</p></span>"
        "secciones" => array:4 [
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            "identificador" => "abst0005"
            "titulo" => "Objective"
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          1 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "Methods"
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            "titulo" => "Conclusion"
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        "titulo" => "Resumen"
        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Objetivo</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Determinar causas de hospitalizaci&#243;n en pacientes con lupus eritematoso sist&#233;mico &#40;LES&#41; internados en Hospital de Cl&#237;nicas &#8220;Jos&#233; de San Mart&#237;n&#8221; Buenos Aires&#44; Argentina&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">M&#233;todos</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Se analizaron retrospectivamente historias cl&#237;nicas de pacientes LES &#40;SLICC 2012&#41; durante o previo a la internaci&#243;n&#44; desde 1-2014 hasta 12-2017&#46; Datos demogr&#225;ficos&#44; motivos de hospitalizaci&#243;n&#44; tratamientos&#44; SLEDAI 2&#8239;K y condiciones com&#243;rbidas&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">121 hospitalizaciones correspondientes a 72 pacientes&#44; 25 pacientes &#40;34&#44;7&#37;&#41; tuvieron m&#225;s de una hospitalizaci&#243;n&#46; Mujeres &#40;83&#44;3&#37;&#41;&#44; mediana de duraci&#243;n de la enfermedad hasta la admisi&#243;n 5 a&#241;os&#46; M&#225;s de una causa de internaci&#243;n en 32&#44; total de 164 motivos&#46; La principal causa fue reca&#237;da de la enfermedad &#40;52&#44;4&#37;&#41;&#46; La manifestaci&#243;n m&#225;s frecuente fue compromiso renal&#44; serositis y compromiso pulmonar&#46; Las infecciones fueron la segunda causa de hospitalizaci&#243;n &#40;26&#44;8&#37;&#41;&#59; tracto urinario&#44; neumon&#237;a y partes blandas&#46; Compromiso cardiovascular 4&#44;9&#37;&#46; Hospitalizaci&#243;n en unidad cerrada 14&#44;05&#37;&#44; mortalidad 2&#44;48&#37;&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusi&#243;n</span><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Reca&#237;da de la enfermedad e infecciones&#44; fueron las principales causas de hospitalizaci&#243;n&#59; la admisi&#243;n secundaria a infecci&#243;n fue superior a la reportada en otras series&#46;</p></span>"
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            "titulo" => "Resultados"
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        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Perrotta N&#44; L&#243;pez Meiller MJ&#44; Malah V&#44; Dubinsky D&#46; Causas de internaci&#243;n en pacientes con lupus eritematoso sist&#233;mico en un hospital universitario de Buenos Aires&#46; Reumatol Clin&#46; 2021&#59;17&#58;471&#8211;474&#46;</p>"
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                  <table border="0" frame="\n
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                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Female sex&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">60 &#40;83&#46;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Age &#40;mean&#8239;&#177;&#8239;SD&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">40 &#40;&#177; 16&#46;43&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Disease duration in years &#40;range&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5 &#40;0&#8722;35&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Corticosteroids&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">91&#47;121&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Corticosteroids &#62; 10&#8239;mg&#47;d&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">27&#47;121&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Median SLEDAI &#40;range&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5 &#40;0&#8722;27&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Activity mean &#40;SLEDAI&#8239;&#62;&#8239;4&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">31&#47;121&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">High activity &#40;SLEDAI&#8239;&#62;&#8239;10&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">37&#47;121&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">Very high activity &#40;SLEDAI&#8239;&#62;&#8239;19&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">10&#47;121&nbsp;\t\t\t\t\t\t\n
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          "leyenda" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">AOS&#58; Ascitic oedematous syndrome&#59; CA&#58; Cancer&#59; DVT&#47;PTE&#58; Deep vein thrombosis&#47;pulmonary thromboembolism&#59; FUO&#58; Fever of unknown origin&#59; HZ&#58; Herpes zoster&#59; LL&#58; Lower limb&#59; UTI&#58; Urinary tract infection&#46;</p>"
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                  <table border="0" frame="\n
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                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Reasons for hospitalizationN&#58;164&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">86 &#40;52&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Renal&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">30 &#40;34&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Serositis&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">10 &#40;11&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Pulmonary&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9 &#40;10&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Articular&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;9&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Mucocutaneous&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;8&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Haematological&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;8&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Gastric&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6 &#40;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Neurological&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5 &#40;5&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Cardiac&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 &#40;4&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Infections&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">44 &#40;26&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">UTI&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12 &#40;27&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Pneumonia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11 &#40;25&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Skin and BP&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6 &#40;13&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Gynaecological&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;6&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Without focusBacteriaemia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;6&#46;8&#41;3 &#40;6&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">ProsthesisHZ&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;4&#46;6&#41;1 &#40;2&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Septic arthritis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;2&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">SyphilisAbdominal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;2&#46;3&#41;1 &#40;2&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Cardiovascular&#40;AMI&#44; valvopathies&#44; heart failure&#44; cardiogenic shock&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6 &#40;4&#46;96&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">OTHER&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">28 &#40;17&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Obstetric&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5 &#40;17&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Drug injection&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 &#40;14&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">DVT&#47;PTE&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 &#40;14&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Studies&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;7&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Psychiatric&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;7&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Vertebral fracture&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;3&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Catastrophic APS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;3&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Lupus cystitis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;3&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Lower back pain&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;3&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">FUO&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;3&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">LL oedema&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;3&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Muscle weakness&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;3&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Myasthenic crisis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;3&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">AOS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;3&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Lung CA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;3&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Epistaxis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;3&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab2713355.png"
              ]
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Article information
ISSN: 21735743
Original language: English
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Idiomas
Reumatología Clínica (English Edition)
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