RT Journal Article
SR Electronic
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
FD The Journal of Rheumatology
SP jrheum.101088
DO 10.3899/jrheum.101088
A1 Xuebing Feng
A1 Yaohong Zou
A1 Wenyou Pan
A1 Xiangdang Wang
A1 Min Wu
A1 Miaojia Zhang
A1 Juan Tao
A1 Yu Zhang
A1 Kuiling Tan
A1 Jin Li
A1 Zhiwei Chen
A1 Xiang Ding
A1 Xian Qian
A1 Zhanyun Da
A1 Meimei Wang
A1 Lingyun Sun
YR 2011
UL http://www.jrheum.org/content/early/2011/03/30/jrheum.101088.abstract
AB 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.