1 Department of Health Research and Policy, Stanford School of Medicine , Stanford, California.
2 Division of Immunology and Rheumatology, Department of Medicine, Stanford School of Medicine , Stanford, California.
J Womens Health (Larchmt). 2017 Nov;26(11):1214-1221. doi: 10.1089/jwh.2017.6334. Epub 2017 Sep 11.
Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that is a source of significantly decreased life expectancy in the United States. This study investigated causes of deaths among males and females with SLE.
This cross-sectional study used the national death certificate database of ∼2.7 million death records in the United States, 2014. SLE was defined using Tenth Revision of the International Classification of Diseases codes: M32.1, M32.9, and M32.8. We compared sex-stratified demographic characteristics and the most commonly listed comorbidities in decedents with and without SLE. Relative risks (RRs) quantified the risk of dying with the most commonly listed comorbidities among decedents with SLE aged ≤50 years compared with non-SLE decedents.
There were 2,036 decedents with SLE in the United States (86.2% female). Female SLE decedents were 22 years younger than non-SLE females (median: 59 years vs. 81 years). This difference was 12 years among male decedents (median: 61 years vs. 73 years). The most frequently listed causes of death among female SLE decedents were septicemia (4.32%) and hypertension (3.04%). In contrast, heart disease (3.70%) and diabetes mellitus with complications (3.61%) were the most common among male SLE decedents. Among younger male decedents, SLE had higher co-occurrence of coagulation/hemorrhagic disorders and chronic renal failure compared with non-SLE (RR = 16.69 [95% confidence interval {CI} = 10.50-27.44] and RR = 5.76 [95% CI = 2.76-12.00], respectively). These also contributed to premature mortality among women (RR = 4.98 [95% CI = 3.69-6.70] and 8.55 [95% CI = 6.89-10.61], respectively).
Our findings identify clinically relevant comorbidities that may warrant careful consideration in patients' clinical management and the natural history of SLE.
系统性红斑狼疮（SLE）是一种慢性自身免疫性疾病，是导致美国人群预期寿命显著降低的一个原因。本研究调查了 SLE 患者的男女死亡原因。
本横断面研究使用了美国国家死亡证明数据库中约 270 万份死亡记录，时间为 2014 年。SLE 使用第十版国际疾病分类（ICD-10）代码进行定义：M32.1、M32.9 和 M32.8。我们比较了有和没有 SLE 的死者的性别分层人口统计学特征和最常见的并发疾病。相对风险（RR）量化了≤50 岁 SLE 死者与非 SLE 死者中最常见的并发疾病死亡风险。
美国有 2036 名 SLE 死者（86.2%为女性）。SLE 女性死者比非 SLE 女性年轻 22 岁（中位数：59 岁 vs. 81 岁）。这一差异在男性死者中为 12 岁（中位数：61 岁 vs. 73 岁）。SLE 女性死者最常见的死因是败血症（4.32%）和高血压（3.04%）。相比之下，心脏病（3.70%）和糖尿病伴并发症（3.61%）是男性 SLE 死者中最常见的死因。在年轻的男性死者中，SLE 与非 SLE 相比，更常伴有凝血/出血障碍和慢性肾衰竭（RR=16.69[95%置信区间（CI）=10.50-27.44]和 RR=5.76[95% CI=2.76-12.00]）。这些也导致了女性的过早死亡（RR=4.98[95% CI=3.69-6.70]和 8.55[95% CI=6.89-10.61]）。
我们的研究结果确定了临床上相关的合并症，这些合并症可能需要在患者的临床管理和 SLE 的自然史中仔细考虑。
