Üsküdar Cansu Döndü, Üsküdar Teke Hava, Korkmaz Cengiz
Department of Rheumatology, Medical Faculty of Eskişehir Osmangazi University, Eskişehir, Turkey.
Department of Hematology, Medical Faculty of Eskişehir Osmangazi University, Eskişehir, Turkey.
Arch Rheumatol. 2017 Mar 21;32(2):141-148. doi: 10.5606/ArchRheumatol.2017.6173. eCollection 2017 Jun.
This study aims to determine the rate, causes, and risk factors of mortality in Turkish systemic lupus erythematosus (SLE) patients and whether age at diagnosis has an effect on mortality or not.
We retrospectively analyzed the data from 221 patients (10 males, 211 females; mean age 41.5±13.5 years; range 18 to 74 years) who were followed-up due to the diagnosis of SLE in our department between January 1998 and March 2016. Detailed clinical findings, organ involvements, autoantibodies, and complement levels of the patients were recorded.
Of the entire group, 19 patients (8.6%) died. Mortality incidence rate was 1.05/100 patient-years. Most frequent causes of death were infections, ischemic cardiovascular and cerebrovascular diseases. Through univariate analysis, older age at diagnosis and a short duration of follow- up were identified as the only factors with an influence on mortality (p=0.004 and p=0.002, respectively). Beyond the mentioned factors, organ involvements in SLE, autoantibodies or antiphospholipid antibody syndrome were not found to have a relationship with mortality. Further analysis conducted on late-onset, defined as the patient age of 50 or above at diagnosis, versus adult-onset, defined as the diagnosis at an age of younger than 50 years, revealed a remarkably shorter survival in patients diagnosed after age of 50 (p=0.003). Cumulative five-year, 10-year, and 15-year survivals of patients were 91.9%, 90%, and 88.2%, respectively.
We identified older age at diagnosis as an effective factor on mortality. SLE patients who are diagnosed at an older age should be more closely and meticulously followed-up than those diagnosed earlier in terms of their mortality risk.
本研究旨在确定土耳其系统性红斑狼疮（SLE）患者的死亡率、死因及危险因素，以及诊断时的年龄是否对死亡率有影响。
我们回顾性分析了1998年1月至2016年3月间在我院因SLE诊断而接受随访的221例患者（10例男性，211例女性；平均年龄41.5±13.5岁；年龄范围18至74岁）的数据。记录了患者详细的临床发现、器官受累情况、自身抗体及补体水平。
在整个队列中，19例患者（8.6%）死亡。死亡率发生率为1.05/100患者年。最常见的死亡原因是感染、缺血性心血管和脑血管疾病。通过单因素分析，诊断时年龄较大和随访时间较短被确定为仅有的对死亡率有影响的因素（分别为p = 0.004和p = 0.002）。除上述因素外，未发现SLE中的器官受累、自身抗体或抗磷脂抗体综合征与死亡率有关。对诊断时年龄为50岁及以上的晚发型患者与诊断时年龄小于50岁的成人型患者进行的进一步分析显示，50岁以后诊断的患者生存期明显较短（p = 0.003）。患者的累积五年、十年和十五年生存率分别为91.9%、90%和88.2%。
我们确定诊断时年龄较大是死亡率的一个影响因素。就死亡风险而言，年龄较大时诊断的SLE患者应比早期诊断的患者接受更密切和细致的随访。
