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Survival analysis of patients with systemic lupus erythematosus in a tertiary hospital in southern Brazil

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Abstract

Systemic lupus erythematosus (SLE) treatments progress over the years. However, the mortality remains higher than in the general population. Few studies have examined SLE patients’ survival in Brazil. This study aims to identify the main characteristics and risk factors to predict mortality and recognize the main causes of death in Brazilian patients with SLE. We retrospectively assessed clinical, demographic, and serological characteristics from 600 patients followed since 2001 in SLE outpatient clinic from Hospital de Clínicas de Porto Alegre. Risk factors for mortality were examined by univariate and multivariate Cox proportional hazards regression analyses. A p < 0.05 was considered significant. There were 527 survivors (87.83%). The main causes of death were cardiovascular disease (17%), infection (17%), and infection and SLE activity (17%). Risk factors for death were age at diagnosis (HR 1.065, CI 95% 1.039–10.092), SLICC damage index (HR 1.299, CI 95% 1.076–1569), antiphospholip syndrome (HR 3.021, CI 95% 1.307–6.985), and metilprednisolone pulse (HR 2.628, CI 95% 1.283–5.383). Antimalarials was a protective factor for death (HR 0.191, CI 95% 0.064–0.570). Cardiovascular disease, infection, and SLE activity associated with infection were the main known causes of deaths in our SLE patients. Secondary antiphospolipid syndrome, highest score in SLICC damage index, advanced age at diagnosis, and high dose of corticosteroids were risk factors for mortality. Antimalarials was an important protective factor.

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Authors and Affiliations

  1. Division of Rheumatology, Department of Internal Medicine, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil

    Jordana Vaz Hendler, Lucian de Souza, Daniele Corrêa de Freitas Zernow, Juliano Guimarães, Thiago Bertotto & Carla Forgiarini Saldanha

  2. Division of Rheumatology, Department of Internal Medicine, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2350, room 645, Porto Alegre, 90035-003, Brazil

    João Carlos Tavares Brenol & Odirlei André Monticielo

Authors
  1. Jordana Vaz Hendler
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  2. Lucian de Souza
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  3. Daniele Corrêa de Freitas Zernow
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  4. Juliano Guimarães
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  5. Thiago Bertotto
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  6. Carla Forgiarini Saldanha
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  7. João Carlos Tavares Brenol
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  8. Odirlei André Monticielo
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Corresponding author

Correspondence to Odirlei André Monticielo.

Ethics declarations

The study protocol was approved by local Ethics Committee and informed consent form was obtained from all participants at the beginning of the study or at the inclusion of new participants.

Funding

This study was supported by grants from the Research Incentive Fund (Fundo de Incentivo à Pesquisa e Eventos, FIPE) of Hospital de Clínicas de Porto Alegre, the Coordination for the Improvement of Higher Education Personnel (Coordenação de Aperfeiçoamento de Pessoal de Nivel Superior, CAPES), and the National Council for Scientific and Technological Development (Conselho Nacional de Desenvolvimento Científico e Tecnológico, CNPq).

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Hendler, J.V., de Souza, L., de Freitas Zernow, D.C. et al. Survival analysis of patients with systemic lupus erythematosus in a tertiary hospital in southern Brazil. Clin Rheumatol 36, 2005–2010 (2017). https://doi.org/10.1007/s10067-017-3735-1

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  • DOI: https://doi.org/10.1007/s10067-017-3735-1

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