1Department of Rheumatology, Leiden University Medical Center, Netherlands.
Lupus. 2014;23(1):31-8. doi: 10.1177/0961203313512540. Epub 2013 Nov 15.
The standardized mortality ratio (SMR) for systemic lupus erythematosus (SLE) is three; SMR increases to six in case of renal involvement. Up to now data on survival in case of neuropsychiatric involvement in SLE (NPSLE) have been scarce, therefore we calculated an SMR for NPSLE. Furthermore, we identified characteristics that influenced survival by Cox regression analyses. All patients suspected of NPSLE in our center since 1989 were evaluated and included in this study when a diagnosis of primary NPSLE could be established. Patient's life/death status was tracked using the civic registries. Thirty-two (19%) of the 169 included NPSLE patients died within a median follow-up period of six years (range 0.5-24 years). This resulted in a significantly increased mortality rate compared to the general population: SMR 9.5 (95% CI 6.7-13.5). Hazard ratios (HRs) were highest in patients with acute confusional state (HR 3.4) and older age at diagnosis of NPSLE (HR 1.1). A decreased mortality risk was seen with the prescription of antiplatelet therapy (HR 0.22). The time period in which NPSLE was diagnosed did not significantly influence survival. Most frequent causes of death were infection and NPSLE itself.
系统性红斑狼疮（SLE）的标准化死亡率（SMR）为三；若合并肾脏受累，SMR 则增至六。迄今为止，关于神经精神性系统性红斑狼疮（NPSLE）患者生存的数据一直很少，因此我们计算了 NPSLE 的 SMR。此外，我们通过 Cox 回归分析确定了影响生存的特征。自 1989 年以来，我们中心所有疑似 NPSLE 的患者均接受了评估，并在确诊为原发性 NPSLE 时纳入本研究。患者的生死状态通过公民登记册进行跟踪。在中位随访 6 年（范围 0.5-24 年）期间，32 例（19%）169 例纳入的 NPSLE 患者死亡。与普通人群相比，死亡率显著升高：SMR 9.5（95%CI6.7-13.5）。在急性意识混乱状态（HR3.4）和 NPSLE 诊断时年龄较大（HR1.1）的患者中，危险比（HR）最高。抗血小板治疗的处方与降低死亡率相关（HR0.22）。NPSLE 诊断的时间段并未显著影响生存。最常见的死亡原因是感染和 NPSLE 本身。
