TY - JOUR T1 - Prognostic Indicators of Hospitalized Patients with Systemic Lupus Erythematosus: A Large Retrospective Multicenter Study in China JF - The Journal of Rheumatology JO - J Rheumatol DO - 10.3899/jrheum.101088 SP - jrheum.101088 AU - Xuebing Feng AU - Yaohong Zou AU - Wenyou Pan AU - Xiangdang Wang AU - Min Wu AU - Miaojia Zhang AU - Juan Tao AU - Yu Zhang AU - Kuiling Tan AU - Jin Li AU - Zhiwei Chen AU - Xiang Ding AU - Xian Qian AU - Zhanyun Da AU - Meimei Wang AU - Lingyun Sun Y1 - 2011/04/01 UR - http://www.jrheum.org/content/early/2011/03/30/jrheum.101088.abstract N2 - Objective To investigate the mortality of hospitalized patients with systemic lupus erythematosus (SLE) and determine the influential factors associated with poor prognosis. Methods Medical records of 1956 SLE inpatients from 15 hospitals during the period January 1, 1999, to December 31, 2009, were reviewed. All patients were followed up in January 2010. Potential factors associated with mortality were analyzed, comparing patients who were living with those who were deceased. The independency of those factors significantly related to death was determined by Cox regression analysis. Results Male to female ratio was 1:15 in this cohort; median age at disease onset was 30 years. Hematologic (70.0%), mucocutaneous (68.2%), musculoskeletal (57.9%), and renal (48.7%) involvements were most often seen in these patients at time of admission. The overall mortality was 8.5% (n = 166), with infection (25.9%), renal failure (19.3%), and neuropsychiatric lupus (18.7%) the leading 3 causes of death. Independent predictors for mortality in this cohort of SLE patients were neuropsychiatric involvement [hazard ratio (HR) 2.19], anemia (HR 1.69), SLEDAI score > 8 at discharge (HR 1.64), increased serum creatinine (HR 1.57), low serum albumin (HR 1.56), cardiopulmonary involvement (HR 1.55), and patient untreated before admission (HR 1.48), whereas the use of antimalarial drugs (HR 0.62) and positive anti-Sm antibody (HR 0.60) were shown to be protective factors. Conclusion SLE patients with delayed treatment and refractory disease have poorer prognosis. A high incidence of death would be expected if they have neuropsychiatric involvement, anemia, azotemia, or cardiopulmonary involvement. Combination therapy with antimalarial drugs may provide some benefit to patients with SLE. ER -