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Good survival rates in systemic lupus erythematosus in southern Sweden, while the mortality rate remains increased compared with the population

Ingvarsson, R. F. LU ; Landgren, A. J. LU ; Bengtsson, A. A. LU and Jönsen, A. LU (2019) In Lupus 28(12). p.1488-1494
Abstract

OBJECTIVE: 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. METHODS: 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... (More)

OBJECTIVE: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
cardiovascular disease, cause of death, mortality, standardized mortality ratio, Systemic lupus erythematosus
in
Lupus
volume
28
issue
12
pages
7 pages
publisher
SAGE Publications Ltd
external identifiers
  • pmid:31551031
  • scopus:85073183546
ISSN
0961-2033
DOI
10.1177/0961203319877947
language
English
LU publication?
yes
id
4e6bd4c6-f305-4d5c-bb1b-a84e01cecc4e
date added to LUP
2019-10-22 14:06:42
date last changed
2019-10-29 05:57:53
@article{4e6bd4c6-f305-4d5c-bb1b-a84e01cecc4e,
  abstract     = {<p>OBJECTIVE: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.</p>},
  author       = {Ingvarsson, R. F. and Landgren, A. J. and Bengtsson, A. A. and Jönsen, A.},
  issn         = {0961-2033},
  language     = {eng},
  number       = {12},
  pages        = {1488--1494},
  publisher    = {SAGE Publications Ltd},
  series       = {Lupus},
  title        = {Good survival rates in systemic lupus erythematosus in southern Sweden, while the mortality rate remains increased compared with the population},
  url          = {http://dx.doi.org/10.1177/0961203319877947},
  doi          = {10.1177/0961203319877947},
  volume       = {28},
  year         = {2019},
}