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Association of the Charlson Comorbidity Index With Mortality in Systemic Lupus Erythematosus

Jönsen, Andreas LU ; Clarke, A. E. ; Joseph, L. ; Belisle, P. ; Bernatsky, S. ; Nived, Ola LU ; Bengtsson, Anders LU ; Sturfelt, Gunnar LU and Pineau, C. A. (2011) In Arthritis Care and Research 63(9). p.1233-1237
Abstract
Objective. To investigate whether comorbidity as assessed by the Charlson Comorbidity Index (CCI) is associated with mortality in a long-term followup of systemic lupus erythematosus (SLE) patients. Methods. Data were collected from 499 SLE patients attending the Lupus Clinic at the McGill University Health Center, Montreal, Quebec, Canada, and 170 SLE patients from the Department of Rheumatology at Lund University Hospital, Lund, Sweden. This included data on comorbidity, demographics, disease activity, the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SDI), and antiphospholipid antibody syndrome (APS). Variables were entered into a Cox proportional hazards survival model. Results.... (More)
Objective. To investigate whether comorbidity as assessed by the Charlson Comorbidity Index (CCI) is associated with mortality in a long-term followup of systemic lupus erythematosus (SLE) patients. Methods. Data were collected from 499 SLE patients attending the Lupus Clinic at the McGill University Health Center, Montreal, Quebec, Canada, and 170 SLE patients from the Department of Rheumatology at Lund University Hospital, Lund, Sweden. This included data on comorbidity, demographics, disease activity, the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SDI), and antiphospholipid antibody syndrome (APS). Variables were entered into a Cox proportional hazards survival model. Results. Mortality risk in the Montreal cohort was associated with the CCI (hazard ratio [HR] 1.57 per unit increase in the CCI, 95% confidence interval [95% CI] 1.18-2.09) and age (HR 1.04 per year increase in age, 95% CI 1.00-1.09). The CCI and age at diagnosis were also associated with mortality in the Lund cohort (CCI: HR 1.35, 95% CI 1.13-1.60; age: HR 1.09, 95% CI 1.05-1.12). Furthermore, the SDI was associated with mortality in the Lund cohort (HR 1.40, 95% CI 1.19-1.64), while a wide CI for the estimate in the Montreal cohort prevented a definitive conclusion (HR 1.20, 95% CI 0.97-1.48). We did not find a strong association between mortality and sex, race/ethnicity, disease activity, or APS in either cohort. Conclusion. In this study, comorbidity as measured by the CCI was associated with decreased survival independent of age, lupus disease activity, and damage. This suggests that the CCI may be useful in capturing comorbidity for clinical research in SLE. (Less)
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author
; ; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Arthritis Care and Research
volume
63
issue
9
pages
1233 - 1237
publisher
John Wiley & Sons Inc.
external identifiers
  • wos:000295254900003
  • scopus:80052304210
  • pmid:21618451
  • pmid:21618451
ISSN
2151-4658
DOI
10.1002/acr.20506
language
English
LU publication?
yes
id
8f6a6543-481a-4300-bc80-a969fb1e6d3e (old id 2179719)
date added to LUP
2016-04-01 10:22:22
date last changed
2022-04-20 01:32:20
@article{8f6a6543-481a-4300-bc80-a969fb1e6d3e,
  abstract     = {{Objective. To investigate whether comorbidity as assessed by the Charlson Comorbidity Index (CCI) is associated with mortality in a long-term followup of systemic lupus erythematosus (SLE) patients. Methods. Data were collected from 499 SLE patients attending the Lupus Clinic at the McGill University Health Center, Montreal, Quebec, Canada, and 170 SLE patients from the Department of Rheumatology at Lund University Hospital, Lund, Sweden. This included data on comorbidity, demographics, disease activity, the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SDI), and antiphospholipid antibody syndrome (APS). Variables were entered into a Cox proportional hazards survival model. Results. Mortality risk in the Montreal cohort was associated with the CCI (hazard ratio [HR] 1.57 per unit increase in the CCI, 95% confidence interval [95% CI] 1.18-2.09) and age (HR 1.04 per year increase in age, 95% CI 1.00-1.09). The CCI and age at diagnosis were also associated with mortality in the Lund cohort (CCI: HR 1.35, 95% CI 1.13-1.60; age: HR 1.09, 95% CI 1.05-1.12). Furthermore, the SDI was associated with mortality in the Lund cohort (HR 1.40, 95% CI 1.19-1.64), while a wide CI for the estimate in the Montreal cohort prevented a definitive conclusion (HR 1.20, 95% CI 0.97-1.48). We did not find a strong association between mortality and sex, race/ethnicity, disease activity, or APS in either cohort. Conclusion. In this study, comorbidity as measured by the CCI was associated with decreased survival independent of age, lupus disease activity, and damage. This suggests that the CCI may be useful in capturing comorbidity for clinical research in SLE.}},
  author       = {{Jönsen, Andreas and Clarke, A. E. and Joseph, L. and Belisle, P. and Bernatsky, S. and Nived, Ola and Bengtsson, Anders and Sturfelt, Gunnar and Pineau, C. A.}},
  issn         = {{2151-4658}},
  language     = {{eng}},
  number       = {{9}},
  pages        = {{1233--1237}},
  publisher    = {{John Wiley & Sons Inc.}},
  series       = {{Arthritis Care and Research}},
  title        = {{Association of the Charlson Comorbidity Index With Mortality in Systemic Lupus Erythematosus}},
  url          = {{http://dx.doi.org/10.1002/acr.20506}},
  doi          = {{10.1002/acr.20506}},
  volume       = {{63}},
  year         = {{2011}},
}