Abstract
In this Danish multicentre study, predictive clinical factors of mortality and survival were calculated for 513 patients with systemic lupus erythematosus (SLE), 122 of whom died within a mean observation period of 8.2 years equalling a mortality rate of 2.9% per year. Survival rates were 97%, 91%, 76% and 64% after 1, 5, 10 and 15 years, respectively. The direct causes of death included SLE (n=35_, infections (n=25), malignancy (n=9), cardiovascular disease (n=32) and other causes (n=21). Uni-and multivariate analyses of survival and mortality were performed for all deaths and for SLE-related deaths. Azotaemia (one-fifth of the patients) was a strong predictor of increased overall and SLE-related mortality, but nephropathy per se (one-half of the patients) and large proteinuria (one-sixth of the patients) were unrelated to survival. Haemolytic anaemia had a significant negative influence on survival related to mortality caused by infections. Diffuse central nervous system disease and myocarditis were related to increased SLE-related mortality, whereas photosensitivity predicted a decreased mortality. Non-fatal infections and thrombotic events predicted a decreased overall survival. Since 1980 the mortality caused by SLE manifestations has decreased significantly.
Similar content being viewed by others
References
Ward MM, Pyun E, Studenski S. Mortality risks associated with specific clinical manifestations of systemic lupus erythematosus. Arch Intern Med 1996;156:1337–44.
Halberg P, Alsbjørn B, Balsløv JT, et al. Systemic lupus erythematosus. Follow-up study of 148 patients. II: Predictive factors of importance for course and outcome. Clin Rheumatol 1987;6:22–6.
Reveille JD, Bartolucci A, Alarcón GS. Prognosis in systemic lupus erythematosus. Negative impact of increasing age at onset, black race, and thrombocytopenia, as well as causes of death. Arthritis Rheum 1990;33:37–48.
Ward MM, Pyun E, Studenski S. Long-term survival in systemic lupus erythematosus. Patient characteristics associated with poorer outcomes. Arthritis Rheum 1995;38:274–83.
Swaak AJG, Nossent JC, Bronsweld W, et al. Systemic lupus erythematosus. I. Outcome and survival: Dutch experience with 110 patients studied prospectively. Ann Rheum Dis 1989;48:447–54.
Goulet J-R, MacKenzie T, Levinton C, Hayslett JP, Ciampi A, Esdaile JM. The longterm prognosis of lupus nephritis: the impact of disease activity. J Rheumatol 1993;20:59–65.
Ginzler EM, Felson DT, Anthony JM, Anderson JJ. Hypertension increases the risk of renal deterioration in systemic lupus erythematosus. J Rheumatol 1993;20:1694–700.
Ward MM, Studenski S. Age associated clinical manifestations of systemic lupus erythematosus: a multivariate regression analysis. J Rheumatol 1990;17:476–81.
Ward MM, Studenski S. Systemic lupus erythematosus in men: a multivariate analysis of gender differences in clinical manifestations. J Rheumatol 1990;17:220–4.
Jacobsen S, Petersen J, Ullman S, et al. A multicenter study of 513 Danish patients with systemic lupus erythematosus. I: Disease manifestations and analyses of clinical subsets. Clin Rheumatol 1998;17:468–77.
Tan EM, Cohen AS, Fries JF. The 1982 revised criteria for the classification of systemic lupus erythematosus (SLE). Arthritis Rheum 1982;25:1271–7.
Dean AG, Dean JA, Coulombier D, et al. Epi Info, Version 6: a word processing, database, and statistics program for epidemiology on microcomputers. Atlanta, Georgia, USA: Centers for Disease Control and Prevention, 1994.
Petri M. Thrombosis and systemic lupus erythematosus: the Hopkins lupus cohort perspective. Scand J Rheumatol 1996; 25:191–3.
Nived O, Sturfelt G, Wollheim F. Systemic lupus erythematosus and infection: a controlled and prospective study including an epidemiological group. Arthritis Rheum 1994;37:559–67.
Ginzler EM, Schorn K. Outcome and prognosis in systemic lupus erythematosus. Rheum Dis Clin North Am 1988;14:67–78.
Urowitz MB, Gladman DD, Abu-Shakra M, Farewell VT. Mortality studies in systemic lupus erythematosus. Results from a single center. III. Improved survival over 24 years. J Rheumatol 1997;24:1061–5.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Jacobsen, S., Petersen, J., Ullman, S. et al. A multicentre study of 513 Danish patients with systemic lupus erythematosus. II. Disease mortality and clinical factors of prognostic value. Clin Rheumatol 17, 478–484 (1998). https://doi.org/10.1007/BF01451283
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF01451283