Adwan Marwan H, Qasem Ula, Mustafa Khader N
Department of Internal Medicine, Division of Rheumatology, The University of Jordan, Jordan University Hospital, Queen Rania Street, PO Box 13046, Amman, 11942, Jordan.
Rheumatol Int. 2020 May;40(5):711-717. doi: 10.1007/s00296-020-04538-z. Epub 2020 Mar 7.
We aimed to study the mortality among hospitalized patients with systemic lupus erythematosus (SLE). We performed a retrospective cross-sectional study and identified patients with SLE who were hospitalized at Jordan University Hospital (JUH) between 2002 and 2017.There were 990 admissions among which 283 were SLE patients. The mean age at disease onset was 34 ± 12.5 years and the female to male ratio was 8.4:1. Forty patients died during the 15-year period. In-hospital case fatality was 14% over 15 years. For the deceased patients, the female to male ratio was 3.4:1, mean age at disease onset was 27.8 ± 11.5 years, mean age at death was 35.1 ± 12 years, and mean disease duration was 7.5 ± 6.9 years. Twenty patients had disease duration ≤ 5 years. Infection and SLE-related complication contributed equally to mortality in hospitalized SLE patients (42.5% [CI 27.5%-59%] and 40% [95% CI 25%-56.5%], respectively). Infection related mortality compared to SLE-related mortality was associated with younger age and shorter disease duration (29.5 years versus 38.3 years and 6.4 versus 8.7 years, respectively). CRP was higher in infection related mortality compared to SLE-related mortality (131.4 mg/dl versus 87.6 mg/dl, respectively). Most SLE-related deaths were secondary to pulmonary disease. Renal disease did not contribute directly to mortality. No fatalities were attributed to cardiovascular disease (CVD) or cancer. Infection and active SLE accounted for the majority of deaths at a young age. Significant pulmonary related deaths may indicate a change in trends in SLE mortality, as renal related mortality is expected to decline due to proper management.
我们旨在研究住院系统性红斑狼疮（SLE）患者的死亡率。我们进行了一项回顾性横断面研究，确定了2002年至2017年期间在约旦大学医院（JUH）住院的SLE患者。共有990例入院病例，其中283例为SLE患者。疾病发病的平均年龄为34±12.5岁，女性与男性比例为8.4:1。在这15年期间，有40例患者死亡。15年间的院内病死率为14%。对于死亡患者，女性与男性比例为3.4:1，疾病发病的平均年龄为27.8±11.5岁，死亡的平均年龄为35.1±12岁，平均病程为7.5±6.9年。20例患者病程≤5年。感染和SLE相关并发症在住院SLE患者死亡率中的占比相同（分别为42.5%[CI 27.5%-59%]和40%[95%CI 25%-56.5%]）。与SLE相关死亡率相比，感染相关死亡率与更年轻的年龄和更短的病程相关（分别为29.5岁对38.3岁以及6.4年对8.7年）。与SLE相关死亡率相比，感染相关死亡率的CRP更高（分别为131.4mg/dl对87.6mg/dl）。大多数SLE相关死亡继发于肺部疾病。肾脏疾病并非直接导致死亡。没有死亡病例归因于心血管疾病（CVD）或癌症。感染和活动性SLE占年轻时死亡的大多数。显著的肺部相关死亡可能表明SLE死亡率趋势的变化，因为由于恰当的管理，预计肾脏相关死亡率会下降。
