Department of Clinical Sciences Lund, Rheumatology, Lund University, Lund, Sweden.
Department of Internal Medicine, Landspitali University Hospital, Reykjavik, Iceland.
Lupus. 2019 Oct;28(12):1488-1494. doi: 10.1177/0961203319877947. Epub 2019 Sep 24.
To ascertain the mortality rate and causes of death in patients with systemic lupus erythematosus (SLE) within a defined region in southern Sweden during the time period 1981-2014 and determine whether these have changed over time.
In 1981, a prospective observation study of patients with SLE was initiated in southern Sweden. All incident SLE patients within a defined geographic area were identified using previously validated methods including diagnosis and immunology registers. Patients with a confirmed SLE diagnosis were then followed prospectively at the Department of Rheumatology in Lund. Clinical data was collected at regular visits. Patients were recruited from 1981 to 2006 and followed until 2014. The patient cohort was split into two groups based on the year of diagnosis to determine secular trends. Causes of death were retrieved from medical records and from the cause of death registry at The National Board of Health and Welfare in Sweden.
In all, 175 patients were diagnosed with SLE during the study period. A total of 60 deaths occurred during a total of 3053 years of follow-up. In the first half of the study inclusion period 46 patients died, compared with 14 in the latter. The majority of patients (51.7%) died of cardiovascular disease. Infections caused 15% of the deaths and malignancy was the cause of death in 13.3% of patients. SLE was the main cause of death for 6.7% of the patients and a contributing factor for half of the patients. Standardized mortality ratio was increased in patients by a factor of 2.5 compared with the general population. Deaths occurred at an even rate throughout the whole observation period. No significant difference in standardized mortality ratio was observed between genders but was increased in older female patients. Furthermore, secular mortality trends were not identified.
In this long-term epidemiologic follow-up study of incident SLE, we report a substantially raised mortality rate amongst SLE patients compared with the general population. The mortality rates have not changed significantly during the observation period that spanned three decades. The main cause of death was cardiovascular disease and this finding was consistent over time.
确定在瑞典南部一个特定地区 1981-2014 年期间系统性红斑狼疮（SLE）患者的死亡率和死亡原因，并确定这些死亡率是否随时间而变化。
1981 年，在瑞典南部启动了一项对 SLE 患者的前瞻性观察研究。使用先前验证的方法，包括诊断和免疫学登记册，确定了特定地理区域内所有确诊的 SLE 患者。然后，在隆德风湿病科对确诊的 SLE 患者进行前瞻性随访。定期就诊时收集临床数据。患者于 1981 年至 2006 年招募，并随访至 2014 年。根据诊断年份将患者队列分为两组，以确定时间趋势。从病历和瑞典国家卫生福利委员会的死因登记处检索死因。
在研究期间，共有 175 名患者被诊断为 SLE。在总共 3053 年的随访期间，共有 60 人死亡。在前半段研究期间，有 46 名患者死亡，而在后半段则有 14 名患者死亡。大多数患者（51.7%）死于心血管疾病。感染导致 15%的死亡，恶性肿瘤导致 13.3%的患者死亡。SLE 是 6.7%的患者的主要死因，也是一半患者的死亡原因之一。与普通人群相比，患者的标准化死亡率增加了 2.5 倍。在整个观察期间，死亡率均匀发生，没有观察到性别之间的标准化死亡率差异，但在老年女性患者中有所增加。此外，没有发现时间趋势的死亡率变化。
在这项对新诊断 SLE 的长期流行病学随访研究中，我们报告 SLE 患者的死亡率明显高于普通人群。在观察期跨越三十年的时间里，死亡率没有显著变化。主要死因是心血管疾病，这一发现随着时间的推移保持不变。
