Table IV. Major comorbidities in the end-of-life hos- pitalization of patients with SLE during 2005-2007 (N = 302) Comorbidities Sepsis or bacteremia Acute respiratory failure Shock, non-traumatic Acute myocardial infarction Acute cerebrovascular accident Acute lower respiratory conditions Urological infections Peptic ulcer or esophagitis Hypertensive diseases Heart failure Diabetes mellitus Cancers Nephropathy/nephritis For the costs and pathway of care in end-of-life SLE Regarding the medical costs for SLE, Pelletier et al. reported an impact of co-existing nephropa- thy on higher inpatient and outpatient expenses [14]. In the USA, the inpatient costs for SLE have increased to a mean of 10,000 USD for each admis- sion [6]. In Taiwan, the mean inpatient cost for SLE was lower than those in the USA, totaling 1,923 USD for each admission [10]. In this study, the mean cost for each end-of-life hospitalization was more expensive (9,530 ±10,354 USD) than those report- Table V. Correlation of individual factors with each other in SLE patients approaching death, calculated by multi- variate logistic regression B –0.974 0.880 1.935 1.022 0.566 –2.006 0.733 –1.092 0.901 –0.855 1.852 –2.716 OR 0.377 2.411 6.926 2.778 1.761 0.135 2.081 0.336 2.463 0.425 6.369 0.113 95% CI 0.181-0.789 1.282-4.535 2.264-21.187 1.300-5.935 1.080-2.871 0.031-0.582 1.235-3.506 0.122-0.921 1.312-4.608 0.194-0.933 3.304-12.277 0.014-0.911 thy/nephritis correlated positively with hospital stays of more than 14 days (B = 0.566, OR = 1.761). The ALRC was closely associated with acute respiratory failure (B = 0.733, OR = 2.081), but not with non-trau- matic shock (B = –0.855, OR = 0.425). Indeed, non- traumatic shock tended to be associated with short- er hospital stays (≤ 14 days, B = 0.901, OR = 2.463) and sepsis/bacteremia (B = 1.852, OR = 6.369). On the other hand, cancers occurred less frequently in subjects with nephropathy/nephritis (B = –2.006, OR = 0.135), acute respiratory failure (B = –1.092, OR = 0.336), or non-traumatic shock (B = –2.716, OR = 0.113). Discussion For demographic characteristics and the role of rheumatologists As demonstrated in Table II, the majority of pa- tients were young females, consistent with previous reports. Patients were usually admitted to the acute wards and were cared for by internal physicians, indi- cating that complications of lupus disease often develop acutely and are unlikely to require surgical intervention. However, it should be noted that rheumatologists only covered around one third of dead SLE patients for their end-of-life hospitalizations in Taiwan. This phenomenon indicated that SLE itself is manifested with multi-organ involvement and dam- age. Thus, patients with SLE were admitted with lethal complications from different involved organs/systems, for which the specialists were assigned to care. Our results suggest that internal physicians should have relevant knowledge and capacity to care for patients with SLE, and rheumatologists should take more responsibility to consult or combine care for compli- cated SLE patients in Taiwan. Dependent variable Age ≥ 65 years Nephropathy/nephritis Hospital stay > 14 days Acute respiratory failure Shock, non-traumatic Hospital stay ≤ 14 days Covariates Nephropathy/nephritis ALRC Diabetes mellitus Male gender Cancers ALRC Cancers ALRC Cancers Sepsis or bacteremia B – regression coefficient, OR – odds ratio, CI – confidence interval, ALRC – acute lower respiratory condition Arch Med Sci 4, August / 2012 Characteristics of comorbidities and costs among patients who died from systemic lupus erythematosus in Taiwan No. (%) 127 (42.1) 117 (38.7) 63 (20.9) 8 (2.6) 31 (10.3) 81 (26.8) 23 (7.6) 12 (4.0) 32 (10.6) 23 (7.6) 15 (5.0) 27 (8.9) 106 (35.1) Value of p 0.010 0.006 0.001 0.008 0.023 0.007 0.006 0.034 0.005 0.033 < 0.001 0.041 693