Evidence mapPaperPMID 39738803Full record

ArticleClinical rheumatology2025

Frailty in older adults with systemic lupus erythematosus and emergency department utilization: an administrative claims data analysis of Medicare beneficiaries.

Sarah B Lieber, Musarrat Nahid, Iris Navarro-Millán, Mangala Rajan, Sebastian E Sattui, M Carrington Reid, Lisa A Mandl

Abstract read
In one paragraph

Article in Clinical rheumatology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Sarah B LieberDivision of Rheumatology, Hospital for Special Surgery, 535 East 70th Street, New York, NY, 10021, USA. liebers@hss.edu.ORCID http://orcid.org/0000-0002-6176-9740
Musarrat NahidDepartment of Medicine, Weill Cornell Medicine, 530 East 70th Street, New York, NY, USA.
Iris Navarro-MillánDivision of Rheumatology, Hospital for Special Surgery, 535 East 70th Street, New York, NY, 10021, USA.ORCID http://orcid.org/0000-0002-9540-6614
Mangala RajanDepartment of Medicine, Weill Cornell Medicine, 530 East 70th Street, New York, NY, USA.ORCID http://orcid.org/0000-0001-6129-6683
Sebastian E SattuiDivision of Rheumatology and Clinical Immunology, Department of Medicine, University of Pittsburgh, 3500 Terrace Street, Pittsburgh, PA, USA.ORCID http://orcid.org/0000-0002-3945-6828
M Carrington ReidDepartment of Medicine, Weill Cornell Medicine, 530 East 70th Street, New York, NY, USA.ORCID http://orcid.org/0000-0001-8117-662X
Lisa A MandlDivision of Rheumatology, Hospital for Special Surgery, 535 East 70th Street, New York, NY, 10021, USA.ORCID http://orcid.org/0000-0001-6085-8664

Funding

Clinical and Translational Science CenterUL1TR002384 · WEILL MEDICAL COLL OF CORNELL UNIV · 2025 to 2025
$9.8M
Cornell Roybal Center-Translational Research Institute on Pain in Later LifeP30AG022845 · WEILL MEDICAL COLL OF CORNELL UNIV · 2003 to 2025
$2.3M
I. Institutional Career Development CoreKL2TR002385 · WEILL MEDICAL COLL OF CORNELL UNIV · 2025 to 2025
$1.7M
Methods and Health Informatics CoreP30AR072583 · UNIVERSITY OF ALABAMA AT BIRMINGHAM · 2025 to 2025
$618k
Tablet-Based Physical Activity Intervention for Frail and Pre-Frail Older Adults with Systemic Lupus ErythematosusK23AG088502 · HOSPITAL FOR SPECIAL SURGERY · 2025 to 2025
$193k
Reid Aging and Pain Research Training ProgramK24AG053462 · WEILL MEDICAL COLL OF CORNELL UNIV · 2025 to 2025
$187k
Hospital for Special Surgery Fund for the FutureNCATS NIH HHS KL2 TR002385NCATS NIH HHS KL2TR002385NCATS NIH HHS UL1 TR002384NIAMS NIH HHS P30 AR072583NIAMS NIH HHS P30AR072583NIA NIH HHS K23 AG088502NIA NIH HHS K24 AG053462NIA NIH HHS K24AG053462NIA NIH HHS P30 AG022845NIA NIH HHS R03 AG082927
6 · The paper itself

Abstract

INTRODUCTION /

objectivesWhile presence of concomitant SLE and frailty has been associated with greater emergency department (ED) use than SLE alone in young/mid-aged adults, whether frailty increases ED use in older adults with SLE remains unknown. In a nationally representative United States administrative claims dataset, we investigated the association of frailty duration with use of ED services in the SLE population compared with individuals without systemic rheumatic disease (SRD).

methodWe identified Medicare beneficiaries ≥ 65 years with SLE and matched them (1:4) by age and gender with non-SRD comparators with osteoarthritis. Frailty was determined using a claims-based index and examined each study year (1/2006-9/2015). We used mixed-effect Poisson regression to ascertain the effect of frailty duration exposure on the risk of ED visits in those with SLE and in non-SRD participants, adjusting for covariates.

resultsAt baseline (2006), frailty prevalence was similar in participants with SLE (N = 1338; 43.7%) and no SRD (N = 5352; 42.4%) (p = 0.37). Frailty prevalence significantly increased and diverged over time between participants with SLE versus no SRD (67.6% versus 63.7% in 2010 and 83.5% versus 78.1% in 2014) (p < 0.05). As frailty duration increased, risk of ED visits increased in both groups, including after covariate adjustment (SLE: incidence rate ratio [IRR] 1.10, 95% confidence interval [CI] 1.09-1.12; non-SRD: IRR 1.09, 95% CI 1.08-1.10).

conclusionsIn this cohort of older adults, duration of frailty conferred similar increased risk of ED visits among those with and without SLE. This underscores the importance of measuring frailty in older populations with SLE. Key Points • Frailty prevalence was similar at baseline, and increased over time, in participants with SLE and those with no systemic rheumatic disease; however, frailty prevalence increased to a greater extent in those with SLE. • Frailty duration conferred similar increased risk of ED visits among older adults with and without SLE. • This underscores the importance of identifying, preventing, and/or reversing frailty in older populations with SLE and not assuming that SLE alone adequately explains health risks.

Indexed as

Emergency Service, HospitalFrailtyLupus Erythematosus, SystemicAgedAged, 80 and overFemaleHumansMaleMedicarePrevalenceUnited StatesAgingEmergency department useFrailtySystemic lupus erythematosus

Identifiers

PMID39738803
PMCPMC11832216

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.