Mortality and disease related comorbidities in systemic lupus erythematosus: Data from an Egyptian cohort

Abstract

Background Systemic lupus erythematosus (SLE) is a complex autoimmune disorder with significant disease-related comorbidity and considerably high mortality. Aim of the work Explore the survival rates and the spectrum of disease related comorbidities in an Egyptian cohort afflicted by SLE. Methods This is a single center observational cohort study performed in one of the leading medical Schools governmental hospitals for teaching and training in the North African region and Middle East sectors Kasr Alainy School of Medicine—Cairo University. Inclusion criteria: the investigators of the research question went for planned review of the medical records of adult SLE patients ≥16 years classified according to American College of Rheumatology (ACR) 1997 SLE classification criteria set forth by Hochberg, 1997 who received longitudinal clinical care during the time period from 1999 to 2019. Exclusion criteria: patients seen only once, other collagen vascular diseases, endocrinal, cardiovascular, or other multisystem disease diagnosed prior to the onset of SLE. Data analysis Survival was determined from the time of SLE diagnosis to the last contact or date of death. The cumulative probability of survival was estimated using Kaplan–Meier method. Differences in survival between patient groups were determined using the long-rank test. Results The study included records of two hundred and two SLE patients, 184 (91.1%) were females and 18 (8.9%) patients were males. The mean age at the time of diagnosis was 26.71 ± 7.93 years with a mean follow-up between mean: 6.6 ± 4.58 years, 34.15% had damage in at least one of the organ systems by Systemic Lupus International Collaborating Clinics American college of rheumatology damage index SLICC/ACR-DI in the first 6 months. Considering an outcome label of dead or alive at the end of follow-up period, results showed a total of 52 mortalities, 88.5% were females and 11.5% were males, mean age at death onset was 30.9 ± 8.8 years. Results of the Kaplan–Meier survival curve showed an overall cumulative probability of survival at 5, 10, 15, and 20 years after SLE diagnosis was 82.9, 68.8, 51.4, and 20.4%, respectively. Conclusion The cumulative probability of survival at 5, 10, 15, and 20 years after SLE diagnosis was 82.9, 68.8, 51.4, and 20.4%, respectively.

Clinical Presentation and Evolution of Systemic Lupus at the CNHU-HKM of Cotonou (Benin)

“…In the cohort as a whole, 15 deaths were recorded after 6 months of follow-up, representing a death rate of 17.0%. This frequency is higher than those found in Europe [17], North Africa [18] and United States [19]. In sub-Saharan Africa, Teclessou et al [20] and Daboiko et al [21] reported death rates of 22.5% and 22.4% respectively.…”

Risk factors for mortality in systemic lupus erythematosus patients: Analysis of adult and pediatric cohorts in Taiwan

“…1,3,6 The 10-year survival rate in the present study falls within the range of recent investigations (68.8%-94.9%). 4,5,[19][20][21][22] Due to the development of novel pharmaceutical agents, the trend in mortality rates decreased in recent years as compared to that few decades ago. 1,3,23,24 Ethnic, geographic, and secular changes and social-economic differences contribute to the heterogeneity of survival rates in SLE patients.…”

“…[1][2][3] Although the treatment of SLE has progressed in recent decades, its relative risk of mortality is high. [3][4][5][6] The attempt to improve survival in SLE patients cannot neglect the management of risk factors of mortality.…”

Epidemiology of systemic lupus erythematosus in Korea

“…Another multi-center retrospective cohort study reported that the cumulative 5-year survival rate was 96% among Korean SLE patients [ 83 ]. A cohort of SLE patients in a single center in China showed a 5-year survival rate of 93.8% [ 92 ], and an Egyptian study reported that the overall cumulative survival rate was 82.9% at 5 years after SLE diagnosis [ 93 ], which were lower than that in Korea. Further information on mortality and causes for 20, 30, and 40 years would be helpful to ensure a higher quality of life in patients.…”