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Survival rates and risk factors for mortality in systemic lupus erythematosus patients in a Chinese center

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Abstract

This paper aims to study the survival and risk factors affecting the long-term prognosis of Chinese patients with systemic lupus erythematosus (SLE). We collected clinical data of 1,072 SLE patients at the time of diagnosis. The Kaplan-Meier method was used to estimate the survival rate, and the Cox proportional hazard regression model for the risk factors affecting prognosis. Of the original 1,072 recruited SLE patients, 665 (570 females and 95 males) were successfully followed up. Mean follow-up was 5.47 ± 4.62 years. Mean age of onset was 29.4 ± 13.4 years. Eighty-one patients did not survive during follow-up; infection, followed by cardiovascular disease, renal failure and SLE disease activity were the leading causes of death. The 5- and 10-year survival rates were 91.2 and 79.6 %, respectively. Moreover, the 5-year survival rates of female and male patients were 92.6 and 81.6 % respectively, and the 10-year survival rates were 80.8 and 62.3 %, respectively. Univariate analyses indicated that male gender, older age of onset, hypertension, increased blood creatinine levels, and high-density lipoprotein cholesterol at the time of diagnosis of SLE were risk factors for all-cause mortality. After adjusting for potential confounders by multivariate analysis, male gender, older age of onset, and high SLEDAI scores at the time of diagnosis were independent risk factors for all-cause mortality in SLE patients. The long-term survival of Chinese SLE patients is comparable to that of other countries. Older age of onset, high disease activity, and decline in renal function are independent risk factors for mortality in patients with SLE.

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References

  1. Merrell M, Shulman LE (1955) Determination of prognosis in chronic disease, illustrated by systemic lupus erythematosus. J Chronic Dis 1(1):12–32

    Article  CAS  PubMed  Google Scholar 

  2. Manger K, Manger B, Repp R, Geisselbrecht M, Geiger A, Pfahlberg A et al (2002) Definition of risk factors for death, end stage renal disease, and thromboembolic events in a monocentric cohort of 338 patients with systemic lupus erythematosus. Ann Rheum Dis 61(12):1065–1070

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  3. Mok CC, Mak A, Chu WP, To CH, Wong SN (2005) Long-term survival of southern Chinese patients with systemic lupus erythematosus: a prospective study of all age-groups. Medicine (Baltimore) 84(4):218–224

    Article  Google Scholar 

  4. Jacobsen S, Petersen J, Ullman S, Junker P, Voss A, Rasmussen JM et al (1999) Mortality and causes of death of 513 Danish patients with systemic lupus erythematosus. Scand J Rheumatol 28(2):75–80

    Article  CAS  PubMed  Google Scholar 

  5. Hochberg MC (1997) Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum 40(9):1725

    Article  CAS  PubMed  Google Scholar 

  6. Tan EM, Cohen AS, Fries JF, Masi AT, McShane DJ, Rothfield NF et al (1982) The 1982 revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum 25(11):1271–1277

    Article  CAS  PubMed  Google Scholar 

  7. Bombardier C, Gladman DD, Urowitz MB, Caron D, Chang CH (1992) Derivation of the SLEDAI. A disease activity index for lupus patients. The Committee on Prognosis Studies in SLE. Arthritis Rheum 35(6):630–640

    Article  CAS  PubMed  Google Scholar 

  8. Ma YC, Zuo L, Chen JH, Luo Q, Yu XQ, Li Y et al (2006) Modified glomerular filtration rate estimating equation for Chinese patients with chronic kidney disease. J Am Soc Nephrol 17(10):2937–2944

    Article  PubMed  Google Scholar 

  9. Cervera R, Khamashta MA, Font J, Sebastiani GD, Gil A, Lavilla P et al (2003) Morbidity and mortality in systemic lupus erythematosus during a 10-year period: a comparison of early and late manifestations in a cohort of 1,000 patients. Medicine (Baltimore) 82(5):299–308

    Article  Google Scholar 

  10. Rabbani MA, Habib HB, Islam M, Ahmad B, Majid S, Saeed W et al (2009) Survival analysis and prognostic indicators of systemic lupus erythematosus in Pakistani patients. Lupus 18(9):848–855

    Article  PubMed  Google Scholar 

  11. Kasitanon N, Louthrenoo W, Sukitawut W, Vichainun R (2002) Causes of death and prognostic factors in Thai patients with systemic lupus erythematosus. Asian Pac J Allergy Immunol 20(2):85–91

    PubMed  Google Scholar 

  12. Urowitz MB, Bookman AA, Koehler BE, Gordon DA, Smythe HA, Ogryzlo MA (1976) The bimodal mortality pattern of systemic lupus erythematosus. Am J Med 60(2):221–225

    Article  CAS  PubMed  Google Scholar 

  13. Bono L, Cameron JS, Hicks JA (1999) The very long-term prognosis and complications of lupus nephritis and its treatment. QJM 92(4):211–218

    Article  CAS  PubMed  Google Scholar 

  14. Petri M, Perez-Gutthann S, Spence D, Hochberg MC (1992) Risk factors for coronary artery disease in patients with systemic lupus erythematosus. Am J Med 93(5):513–519

    Article  CAS  PubMed  Google Scholar 

  15. Urowitz MB, Ibanez D, Gladman DD (2007) Atherosclerotic vascular events in a single large lupus cohort: prevalence and risk factors. J Rheumatol 34(1):70–75

    PubMed  Google Scholar 

  16. Gustafsson J, Gunnarsson I, Borjesson O, Pettersson S, Moller S, Fei GZ et al (2009) Predictors of the first cardiovascular event in patients with systemic lupus erythematosus—a prospective cohort study. Arthritis Res Ther 11(6):R186

    Article  PubMed Central  PubMed  Google Scholar 

  17. Manzi S, Meilahn EN, Rairie JE, Conte CG, Medsger TA Jr, Jansen-McWilliams L et al (1997) Age-specific incidence rates of myocardial infarction and angina in women with systemic lupus erythematosus: comparison with the Framingham Study. Am J Epidemiol 145(5):408–415

    Article  CAS  PubMed  Google Scholar 

  18. Mok CC, Tang SS, To CH, Petri M (2005) Incidence and risk factors of thromboembolism in systemic lupus erythematosus: a comparison of three ethnic groups. Arthritis Rheum 52(9):2774–2782

    Article  PubMed  Google Scholar 

  19. Urowitz MB, Gladman D, Ibanez D, Bae SC, Sanchez-Guerrero J, Gordon C et al (2010) Atherosclerotic vascular events in a multinational inception cohort of systemic lupus erythematosus. Arthritis Care Res (Hoboken) 62(6):881–887

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  20. Toloza SM, Uribe AG, McGwin G Jr, Alarcon GS, Fessler BJ, Bastian HM et al (2004) Systemic lupus erythematosus in a multiethnic US cohort (LUMINA). XXIII. Baseline predictors of vascular events. Arthritis Rheum 50(12):3947–3957

    Article  PubMed  Google Scholar 

  21. Ward MM, Pyun E, Studenski S (1996) Mortality risks associated with specific clinical manifestations of systemic lupus erythematosus. Arch Intern Med 156(12):1337–1344

    Article  CAS  PubMed  Google Scholar 

  22. Ginzler EM, Diamond HS, Weiner M, Schlesinger M, Fries JF, Wasner C et al (1982) A multicenter study of outcome in systemic lupus erythematosus. I. Entry variables as predictors of prognosis. Arthritis Rheum 25(6):601–611

    Article  CAS  PubMed  Google Scholar 

  23. Tucker LB, Menon S, Schaller JG, Isenberg DA (1995) Adult- and childhood-onset systemic lupus erythematosus: a comparison of onset, clinical features, serology, and outcome. Br J Rheumatol 34(9):866–872

    Article  CAS  PubMed  Google Scholar 

  24. Abu-Shakra M, Urowitz MB, Gladman DD, Gough J (1995) Mortality studies in systemic lupus erythematosus. Results from a single center. II. Predictor variables for mortality. J Rheumatol 22(7):1265–1270

    CAS  PubMed  Google Scholar 

  25. Ward MM, Pyun E, Studenski S (1995) Long-term survival in systemic lupus erythematosus. Patient characteristics associated with poorer outcomes. Arthritis Rheum 38(2):274–283

    Article  CAS  PubMed  Google Scholar 

  26. Maddison P, Farewell V, Isenberg D, Aranow C, Bae SC, Barr S et al (2002) The rate and pattern of organ damage in late onset systemic lupus erythematosus. J Rheumatol 29(5):913–917

    PubMed  Google Scholar 

  27. Molina JF, Drenkard C, Molina J, Cardiel MH, Uribe O, Anaya JM et al (1996) Systemic lupus erythematosus in males. A study of 107 Latin American patients. Medicine (Baltimore) 75(3):124–130

    Article  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450000, Henan Province, China

    Ge Wu, Xiaoyuan Jia, Dan Gao & Zhanzheng Zhao

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  1. Ge Wu
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  2. Xiaoyuan Jia
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  3. Dan Gao
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  4. Zhanzheng Zhao
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Correspondence to Zhanzheng Zhao.

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Wu, G., Jia, X., Gao, D. et al. Survival rates and risk factors for mortality in systemic lupus erythematosus patients in a Chinese center. Clin Rheumatol 33, 947–953 (2014). https://doi.org/10.1007/s10067-014-2596-0

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