Systemic lupus erythematosus. Follow-up study of 148 patients. II: Predictive factors of importance for course and outcome
- 23 Downloads
The predictive value of a number of clinical and laboratory variables for the mortality of 148 patients with systemic lupus erythematosus (SLE) with a mean observation period of 8 years and a 10-year-survival of 80 per cent was calculated by means of differentiated survival rate analyses and stepwise regression analyses. The predictive power of several variables increased if the calculations were based on deaths caused by SLE rather than on the total mortality rate. The survival rate decreased after 1973 because a diagnosis of SLE was made in some patients with terminal disease who would have remained without a diagnosis before that time. The causes of death and the treatment were identical before and after 1973. The presence of a high number of diagnostic ARA criteria within the first year of observation was a predictor of decreased survival. Severe but non-fatal infections (meningitis, septicemia, pneumonia) significantly reduced the survival rate. Patients with proteinuria and azotemia, within the first 2 years of observation, had a 10-year-survival of 70 per cent. The survival of patients with CNS manifestations was not significantly reduced. The butterfly rash and the presence of lymphopenia were predictors of decreased survival, whereas the presence of DNA antibodies had no predictive value for survival.
Key wordsSystemic Lupus Erythematosus Prediction of Outcome
Unable to display preview. Download preview PDF.
- 1.Tan, E.M., Cohen, A.S., Fries, J.F., Meshane, D.J., Rothfield, N.F., Schaller, J.G., Talal, N., Winchester, R.J. The 1982 revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum 1982, 100, 714–727.Google Scholar
- 2.Ginzler, E.M., Diamond, H.S., Weiner, M., Schlesinger, M., Fries, J.F., Wasner, C., Medsger, T.A., Ziegler, G., Klippel, J.M., Hadler, N.M., Albert, D.A., Hess, E.V., Spencer-Green, G., Grayzel, A., Worth, D., Hahn, B.H., Barnett, E.V. A multicenter study of outcome in systemic lupus erythematosus. I: Entry variables as predictors of prognosis. Arthritis Rheum 1982, 25, 601–611.Google Scholar
- 3.Dimant, J., Ginzler, E., Schlesinger, M., Sterba, G., Diamond, H., Kaplan, D., Weiner, M. The clinical significance of Raynaud's phenomenon in systemic lupus erythematosus. Arthritis Rheum 1979, 22, 815–819.Google Scholar
- 4.Davis, B.M., Gilliam, J.N. Prognostic significance of subepidermal immune deposits in uninvolved skin of patients with systemic lupus erythematosus: A 10 year longitudinal study. J Invest Dermatol 1984, 83, 242–247.Google Scholar
- 5.Ludovico, C.L., Zweiman, B., Myers, A.R., Herbert, J., Green, P.A. Predictive value of anti-DNA antibody and selected laboratory studies in systemic lupus erythematosus. J Rheumatol 1980, 7, 843–849.Google Scholar
- 6.Fries, J.F., Hulman, H.J. Systemic lupus erythematosus: A clinical analysis. Philadelphia, W.B. Sounder & Co., 1975, 110.Google Scholar
- 7.Lightfoot, R.W., Hughes, G.R.V. Significance of persisting serologic abnormalities in SLE. Arthritis Rheum 1976, 19, 837–843.Google Scholar
- 8.Swaak, A.J.G., Groenwold, J., Aarden, L.A., Statius van Eps, L.W., Feltkamp, T.E.W. Prognostic value of anti-dsDNA in SLE. Ann Rheum Dis, 1982, 41, 388–395.Google Scholar
- 9.Halberg, P., Alsbjørn, B., Trolle Balslev, I., Lorenzen, I., Gerstoft, I., Ullman, S., Wiik, A. Systemic lupus erythematosus: Follow-up study of 148 patients. I: Classification, clinical and laboratory findings, course and outcome. Clin Rheumatol 1987, 1, 13–21.Google Scholar