Τίτλος:
Current causes of death in systemic lupus erythematosus in Europe,
2000-2004: relation to disease activity and damage accrual
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Current therapeutic and diagnostic resources have turned systemic lupus
erythematosus (SLE) into a chronic disease by reducing mortality rates.
The exact contribution of disease activity and disease related damage to
mortality is not well studied. The aim of this study was to describe the
current causes of death (COD) in a multinational European cohort of
patients with SLE in relation to quantified measures of disease activity
and damage. Prospective five-year observational study of case fatalities
in SLE patients at 12 European centres was performed. Demographics,
disease manifestations, interventions and quantified disease activity
(by ECLAM and SLEDAI) and damage (by SLICC-DI) at the time of death were
related to the various COD. Ninety-one case fatalities (89% females)
occurred after median disease duration of 10.2 years (range 0.2-40)
corresponding to a annual case fatality of one for each of the
participating cohorts. Cumulative mortality correlated linearly with
disease duration with nearly 10% of fatalities occurring in the first
year and 40% after more than 10 years of disease. Death occurred during
SLE remission in one third of cases. In the remaining cases a mixture of
disease activity (median ECLAM 5.5, median SLEDAI 15) and accrued damage
(median SLICC-DI 5.0) with opposing relationships to disease duration
contributed to death. Infections and cardiovascular events were the most
frequent COD in both early and late fatalities with no gender
differences for type of COD, disease activity, damage or comorbidity. In
Europe, case fatalities have become uncommon events in dedicated SLE
cohort,. The bimodal mortality curve has flattened out and deaths now
occur evenly throughout the disease course with infectious and
cardiovascular complications as the main direct COD in both early and
late fatalities. Accrued damage supplants disease activity over time as
the main SLE specific contributor to death over time.
Συγγραφείς:
Nossent, J.
Cikes, N.
Kiss, E.
Marchesoni, A.
Nassonova,
V.
Mosca, M.
Olesinska, M.
Pokorny, G.
Rozman, B. and
Schneider, M.
Vlachoyiannopoulosi, Pg
Swaak, A.
Περιοδικό:
Lupus Science and Medicine
Εκδότης:
SAGE Publications Ltd
Λέξεις-κλειδιά:
cause of death; damage; disease activity; systemic lupus erythematosus;
Europe
DOI:
10.1177/0961203307077987
