A multicentre study of 513 Danish patients with systemic lupus erythematosus. II. Disease mortality and clinical factors of prognostic value

Abstract

In this Danish multicentre study, predictive clinical factors of mortality and survival were calculated for 513 patients with systemic lupus erythematosus (SLE), 122 of whom died within a mean observation period of 8.2 years equalling a mortality rate of 2.9% per year. Survival rates were 97%, 91%, 76% and 64% after 1, 5, 10 and 15 years, respectively. The direct causes of death included SLE (n = 35), infections (n = 25), malignancy (n = 9), cardiovascular disease (n = 32) and other causes (n = 21). Uni- and multivariate analyses of survival and mortality were performed for all deaths and for SLE-related deaths. Azotaemia (one-fifth of the patients) was a strong predictor of increased overall and SLE-related mortality, but nephropathy per se (one-half of the patients) and large proteinuria (one-sixth of the patients) were unrelated to survival. Haemolytic anaemia had a significant negative influence on survival related to mortality caused by infections. Diffuse central nervous system disease and myocarditis were related to increased SLE-related mortality, whereas photosensitivity predicted a decreased mortality. Non-fatal infections and thrombotic events predicted a decreased overall survival. Since 1980 the mortality caused by SLE manifestations has decreased significantly.

A multicentre study of 513 Danish patients with systemic lupus erythematosus. I. Disease manifestations and analyses of clinical subsets

“…Variables allowed in the model are listed below with their corresponding Exp(B) expressing the degree of association, but not the risk ratio (coding: Male sex=l, female sex=0; manifestation present=l, manifestation absent=0) and symptoms at onset in order to identify possible subsets with characteristic courses. The effect of these features on the mortality and survival of the present cohort of SLE patients is described in the following paper [15].…”

Atherogenesis and Vascular Disease in SLE

“…SLE patients have mortality rates of 5-10% at 5 years and 15-30% at 10 years (Abu-Shakra et al, 1995;Jacobsen et al, 1998;Ståhl-Hallengren et al, 2000;Uramoto et al, 1999). This is particularly overwhelming in patients aged less than 55 years (Abu-Shakra et al, 1995).…”

Pulmonary Manifestations of Systemic Lupus Erythematosus

“…(Haupt et al, 1981;Weinrib et al, 1990) The prevalence increases with an increase in the duration of SLE. (Jacobsen et al, 1998) It may present as a chronic and insidious disease or it may follow the development of ALP (Boulware & Hedgpeth, 1989;Weinrib et al, 1990) Chronic ILD occurs more commonly in men and older patients. Pulmonary fibrosis affects 18% of patients above 50 years compared to 2% of patients under 18 years.…”