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Abstract
Background and aims To investigate the mortality and the causes of death in Chinese patients with systemic lupus erythematosus (SLE).
Methods We collected the clinical data of all 950 SLE patients in Rheumatology department of Peking University First Hospital from May 2007 to January 2016.The primary causes of death were identified, the standardised mortality ratio (SMR) and years of life lost (YLL) were calculated based on the National Bureau of Statistics of China for the general population, and the survival was determined by Kaplan-Meier analysis.
Results The mean age of all 950 patients (849 females and 101 males) was 37.9±14.8 years old, the median disease duration at recruitment was 2.7 (0.5–7.0) years, and the median follow-up duration was 4.7 (2.2–8.4) years. Among 881 patients who were successfully traced, 45 patients died. Infection (31.1%) was the leading cause of death followed by lupus nephritis, pulmonary arterial hypertension (PAH) and cerebrovascular disease (Table 1). The overall age and sex adjusted SMR was 3.3 (95%CI 2.3–4.3), and the age adjusted SMR of women and men were 5.1 (3.6–6.7) and 1.3 (0.0–2.6) respectively. The YLL for women and men were 18.1 and 15.0 years respectively (Table 2). The overall survival at 1, 5 and 10 years were 98.2%, 95.3% and 93.7% respectively. The survival of patients with PAH, thrombocytopenia and hemolytic anaemia were significantly worse than those without these complications (Figures 1, 2 and 3).
Causes of death.
The standardized mortality ratio (SMR), life expectancy (LE) and years of life lost (YLL).
Survival curve of SLE patients by PAH.
Survival curve of SLE patients by PAH.
Survival curve of SLE patients by hemolytic anemia.
Conclusions Mortality of SLE patients in China is substantial, especially in female, and infection is the leading death cause. Patients with PAH, thrombocytopenia and hemolytic anaemia had worse prognosis.