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In-hospital mortality in patients with systemic lupus erythematosus: a study from Jordan 2002–2017

  • Epidemiology of RMD
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Abstract

We aimed to study the mortality among hospitalized patients with systemic lupus erythematosus (SLE). We performed a retrospective cross-sectional study and identified patients with SLE who were hospitalized at Jordan University Hospital (JUH) between 2002 and 2017.There were 990 admissions among which 283 were SLE patients. The mean age at disease onset was 34 ± 12.5 years and the female to male ratio was 8.4:1. Forty patients died during the 15-year period. In-hospital case fatality was 14% over 15 years. For the deceased patients, the female to male ratio was 3.4:1, mean age at disease onset was 27.8 ± 11.5 years, mean age at death was 35.1 ± 12 years, and mean disease duration was 7.5 ± 6.9 years. Twenty patients had disease duration ≤ 5 years. Infection and SLE-related complication contributed equally to mortality in hospitalized SLE patients (42.5% [CI 27.5%–59%] and 40% [95% CI 25%–56.5%], respectively). Infection related mortality compared to SLE-related mortality was associated with younger age and shorter disease duration (29.5 years versus 38.3 years and 6.4 versus 8.7 years, respectively). CRP was higher in infection related mortality compared to SLE-related mortality (131.4 mg/dl versus 87.6 mg/dl, respectively). Most SLE-related deaths were secondary to pulmonary disease. Renal disease did not contribute directly to mortality. No fatalities were attributed to cardiovascular disease (CVD) or cancer. Infection and active SLE accounted for the majority of deaths at a young age. Significant pulmonary related deaths may indicate a change in trends in SLE mortality, as renal related mortality is expected to decline due to proper management.

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Authors and Affiliations

  1. Department of Internal Medicine, Division of Rheumatology, The University of Jordan, Jordan University Hospital, Queen Rania Street, PO Box 13046, Amman, 11942, Jordan

    Marwan H. Adwan, Ula Qasem & Khader N. Mustafa

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  1. Marwan H. Adwan
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Contributions

KM had full access to all the data in the study and takes responsibility for the integrity of data and the accuracy of the data analysis. All authors contributed to the study conception and design. Material preparation and data collection were done by KM, UQ. Data analysis, interpretation, and manuscript writing were performed by KM, MA. All authors read and approved the final manuscript.

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Correspondence to Khader N. Mustafa.

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The authors declare that they have no conflict of interest.

Ethical approval

This study was approved by the IRB Committee of Jordan University Hospital (approval number and dates: 2018/62, 30 January 2017).

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Informed consent was waived by IRB because the study was considered minimal risk.

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Adwan, M.H., Qasem, U. & Mustafa, K.N. In-hospital mortality in patients with systemic lupus erythematosus: a study from Jordan 2002–2017. Rheumatol Int 40, 711–717 (2020). https://doi.org/10.1007/s00296-020-04538-z

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