Abstract
Despite the improved survival rate among systemic lupus erythematosus (SLE) patients, there are many factors associated with the mortality of SLE. In the current study, death-related factors of patients associated with course of disease were surveyed. Retrospective study was used. Mortalities among these three groups (group A, B and C, the course of disease was ≤5 years, 5–10 years and >10 years, respectively) were calculated and compared. Various factors related to mortality were analyzed. Male SLE patients died relatively more than female patients. The total mortality was 8.5 %. The mortalities were significant difference in group A, B and C which were 9.4, 4.8 and 8.9 %, respectively. The mortalities of group A and group C were significantly higher than that of group B, but there was no significant difference between mortalities of group A and group C. The most common death-related factor was infection, followed by involved disorders in renal, brain, multisystem, heart, etc. The mortalities resulted from neuropsychiatric systemic lupus erythematosus (NPSLE), pulmonary infection, involved digestive system and hematological system were significantly different between three groups. There was no difference between mortalities of group A and group C associated with pulmonary infection and NPSLE. Patients in group C died more than in group A from involved renal, heart, multisystem, etc, while group A had more patients than group C who died of pulmonary infection, involved hematological system. In conclusion, Male SLE patients have worse outcome than female patients. Infection and active SLE are not only contributors to the death of early stage patients, but also to that of later stage patients.
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References
Kasitanon N, Magder LS, Petri M (2006) Predictors of survival in systemic lupus erythematosus. Medicine (Baltimore) 85:147–156
Cervera R, Khamashta MA, Font J et al (2003) Morbility 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) 82:299–308
Bernatsky S, Boivin JF, Joseph L et al (2006) Mortality in systemic lupus erythematosus. Arthritis Rheum 54:2550–2557
Abu-Shakra M, Gladman DD, Urowitz MB (2004) Mortality studies in SLE: how far can we improve survival of patients with SLE. Autoimmun Rev 3:418–420
Doria A, Laccarino L, Ghirardello A et al (2006) Long-term prognosis and causes of death in systemic lupus erythematosus. Am J Med 119:700–706
Rubin LA, Urowitz MB, Gladman DD (1985) Mortality in systemic lupus erythematosus: the bimodal pattern revisited. Q J Med 55:87–89
Deng DQ, Xie H et al (2008) Causes of death for 43 patients of systemic lupus erythematosus. Chin J Rheumatol 12:285
Fei YY, Zhang FC (2008) Mortality and causes of death of systemic lupus erythematosus in the past two decades. Chin J Rheumatol 12:187–191
Alamanos Y, Voulgari PV, Papassava M et al (2003) Survival and mortality rates of systemic lupus erythematosus patients in northwest Greece. Study of a 21-year incidence cohort. Rheumatology 42:1122–1123
Specker C, Becker A, Lakomek HJ et al (1994) Systemic lupus erythematosus in men—a different prognosis? Z Rheumatol 53:339–345
Li H, Li X, Chu G et al (2000) A clinic analysis of 62 male patients with lupus nephritis. Zhongguo Yi Xue Ke Xue Yuan Xue Bao 22:395–397
Mayor AM, Vilá LM (2003) Gender differences in a cohort of Puerto Ricans with systemic lupus erythematosus. Cell Mol Biol (Noisy-le-grand) 49:1339–1344
Kaufman LD, Gomez-Reino JJ, Heinicke MH et al (1989) Male lupus: retrospective analysis of the clinical and laboratory features of 52 patients, with a review of the literature. Semin Arthritis Rheum 18:189–197
Feng X, Zou Y, Pan W et al (2011) Prognostic indicators of hospitalized patients with systemic lupus erythematosus: a large retrospective multicenter study in China. J Rheumatol 38:1289–1295
Rabbani MA, Habib HB, Islam M et al (2009) Survival analysis and prognostic indicators of systemic lupus erythematosus in Pakistani patients. Lupus 18:845–855
Fessler BJ (2002) Infectious diseases in systemic lupus erythematosus: risk factors, management and prophylaxis. Best Pract Res Clin Rheumatol 16:281–291
Abu-Shakra M, Urowitz MB, Gladman DD et al (1995) Mortality study in systemic lupus erythematosus. Results from a sinde center. 1. Causes of death. J Rheumatol 22:1259–1264
Wadee S, Tikly M, Hopley M (2007) Causes and predictors of death in South Africans with systemic lupus erythematosus. Rheumatology 46:1487–1491
Acknowledgments
This study was partly supported by grants from Cinkate Pharmaceutical Company. The authors thank all investigators who participated in this study and all the study subjects for their participation. Thanks to Xiang-pei LI, Department of Rheumatology, Anhui Provincial Hospital, Hefei, China, and Yi-ping WANG, Westmead Millennium Institute, University of Sydney at Westmead Hospital, Australia, for the preparation of this article.
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Zhen, J., Ling-yun, S., Yao-hong, Z. et al. Death-related factors of systemic lupus erythematosus patients associated with the course of disease in Chinese populations: multicenter and retrospective study of 1,958 inpatients. Rheumatol Int 33, 1541–1546 (2013). https://doi.org/10.1007/s00296-012-2605-z
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DOI: https://doi.org/10.1007/s00296-012-2605-z