RT Journal Article SR Electronic T1 Mortality Profile Related to Systemic Lupus Erythematosus: A Multiple Cause-of-death Analysis JF The Journal of Rheumatology JO J Rheumatol FD The Journal of Rheumatology SP jrheum.110241 DO 10.3899/jrheum.110241 A1 Deborah C.C. Souza A1 Augusto H. Santo A1 Emilia I. Sato YR 2012 UL http://www.jrheum.org/content/early/2012/01/12/jrheum.110241.abstract AB Objective To analyze the mortality profile related to systemic lupus erythematosus (SLE) in the state of São Paulo, Brazil. Methods For the 1985-2007 period, we analyzed all death certificates (n = 4815) on which SLE was listed as an underlying (n = 3133) or non-underlying (n = 1682) cause of death. We evaluated sex, age, and the causes of death, comparing the first and last 5 years of the period, as well as determining the observed/expected death ratio (O/E ratio). Results For SLE as an underlying cause, the mean age at death was 35.77 years (SD 15.12) and the main non-underlying causes of death were renal failure, circulatory system diseases, pneumonia, and septicemia. Over the period, the proportional mention of infectious causes and circulatory system diseases increased, whereas renal diseases decreased. For SLE as a non-underlying cause of death, the most common underlying causes of death were circulatory, respiratory, genitourinary, and digestive system diseases, and certain infections. The overall death O/E ratio was > 1 for renal failure, tuberculosis, septicemia, pneumonia, and digestive system diseases, as well as for circulatory system diseases at < 50 years of age, particularly acute myocardial infarct. Conclusion Unlike in developed countries, renal failure and infectious diseases are still the most frequent causes of death. The increase in SLE deaths associated with infection, especially pneumonia and septicemia, is worrisome. The judicious use of immunosuppressive therapy together with vigorous treatment of cardiovascular comorbidities is crucial to the successful management of SLE and to improving survival of patients with SLE.