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Mortality in systemic lupus erythematosus

Bernatsky, S.; Boivin, J. -F.; Joseph, L.; Manzi, S.; Ginzler, E.; Gladman, D. D.; Urowitz, M.; Fortin, P. R.; Petri, M. and Barr, S., et al. (2006) In Arthritis and Rheumatism 54(8). p.2550-2557
Abstract
Objective. To examine mortality rates in the largest systemic lupus erythematosus (SLE) cohort ever assembled. Methods. Our sample was a multisite international SLE cohort (23 centers, 9,547 patients). Deaths were ascertained by vital statistics registry linkage. Standardized mortality ratio (SMR; ratio of deaths observed to deaths expected) estimates were calculated for-all deaths and by cause. The effects of sex, age, SLE duration, race, and calendar-year periods were determined. Results. The overall SMR was 2.4 (95% confidence interval 2.3-2.5). Particularly high mortality was seen for circulatory disease, infections, renal disease, non-Hodgkin's lymphoma, and lung cancer. The highest SMR estimates were seen in patient groups... (More)
Objective. To examine mortality rates in the largest systemic lupus erythematosus (SLE) cohort ever assembled. Methods. Our sample was a multisite international SLE cohort (23 centers, 9,547 patients). Deaths were ascertained by vital statistics registry linkage. Standardized mortality ratio (SMR; ratio of deaths observed to deaths expected) estimates were calculated for-all deaths and by cause. The effects of sex, age, SLE duration, race, and calendar-year periods were determined. Results. The overall SMR was 2.4 (95% confidence interval 2.3-2.5). Particularly high mortality was seen for circulatory disease, infections, renal disease, non-Hodgkin's lymphoma, and lung cancer. The highest SMR estimates were seen in patient groups characterized by female sex, younger age, SLE duration < 1 year, or black/African American race. There was a dramatic decrease in total SMR estimates across calendar-year periods, which was demonstrable for specific causes including death due to infections and death due to renal disorders. However, the SMR due to circulatory diseases tended to increase slightly from the 1970s to the year 2001. Conclusion. Our data from a very large multicenter international cohort emphasize what has been demonstrated previously in smaller samples. These results highlight the increased mortality rate in SLE patients compared with the general population, and they suggest particular risk associated with female sex, younger age, shorter SLE duration, and black/African American race. The risk for certain types of deaths, primarily related to lupus activity (such as renal disease), has decreased over time, while the risk for deaths due to circulatory disease does not appear to have diminished. (Less)
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Arthritis and Rheumatism
volume
54
issue
8
pages
2550 - 2557
publisher
John Wiley & Sons
external identifiers
  • wos:000239641400024
  • pmid:16868977
  • scopus:33746936116
ISSN
1529-0131
DOI
10.1002/art.21955
language
English
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yes
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497f455d-dab2-496d-903a-2d4623804cdb (old id 398527)
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2007-09-28 10:43:05
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2019-09-15 03:37:44
@article{497f455d-dab2-496d-903a-2d4623804cdb,
  abstract     = {Objective. To examine mortality rates in the largest systemic lupus erythematosus (SLE) cohort ever assembled. Methods. Our sample was a multisite international SLE cohort (23 centers, 9,547 patients). Deaths were ascertained by vital statistics registry linkage. Standardized mortality ratio (SMR; ratio of deaths observed to deaths expected) estimates were calculated for-all deaths and by cause. The effects of sex, age, SLE duration, race, and calendar-year periods were determined. Results. The overall SMR was 2.4 (95% confidence interval 2.3-2.5). Particularly high mortality was seen for circulatory disease, infections, renal disease, non-Hodgkin's lymphoma, and lung cancer. The highest SMR estimates were seen in patient groups characterized by female sex, younger age, SLE duration &lt; 1 year, or black/African American race. There was a dramatic decrease in total SMR estimates across calendar-year periods, which was demonstrable for specific causes including death due to infections and death due to renal disorders. However, the SMR due to circulatory diseases tended to increase slightly from the 1970s to the year 2001. Conclusion. Our data from a very large multicenter international cohort emphasize what has been demonstrated previously in smaller samples. These results highlight the increased mortality rate in SLE patients compared with the general population, and they suggest particular risk associated with female sex, younger age, shorter SLE duration, and black/African American race. The risk for certain types of deaths, primarily related to lupus activity (such as renal disease), has decreased over time, while the risk for deaths due to circulatory disease does not appear to have diminished.},
  author       = {Bernatsky, S. and Boivin, J. -F. and Joseph, L. and Manzi, S. and Ginzler, E. and Gladman, D. D. and Urowitz, M. and Fortin, P. R. and Petri, M. and Barr, S. and Gordon, C. and Bae, S. -C. and Isenberg, D. and Zoma, A. and Aranow, C. and Dooley, M. -A. and Nived, Ola and Sturfelt, Gunnar and Steinsson, K. and Alarcon, G. and Senecal, J. -L. and Zummer, M. and Hanly, J. and Ensworth, S. and Pope, J. and Edworthy, S. and Rahman, A. and Sibley, J. and El-Gabalawy, H. and McCarthy, T. and Pierre, Y. St. and Clarke, A. and Ramsey-Goldman, R.},
  issn         = {1529-0131},
  language     = {eng},
  number       = {8},
  pages        = {2550--2557},
  publisher    = {John Wiley & Sons},
  series       = {Arthritis and Rheumatism},
  title        = {Mortality in systemic lupus erythematosus},
  url          = {http://dx.doi.org/10.1002/art.21955},
  volume       = {54},
  year         = {2006},
}