EXTENDED REPORT

Outcome of a cohort of 300 patients with systemic lupus erythematosus attending a dedicated clinic for over two decades

K E Moss, Y Ioannou, S M Sultan, I Haq, D A Isenberg

Centre for Rheumatology, Bloomsbury Rheumatology Unit, Department of Medicine, University College, London W1P 9PG, UK

Correspondence to:
Correspondence to:
Dr K Moss, Centre for Rheumatology, 4th Floor, Arthur Stanley House, 40–50 Tottenham Street, London W1P 9PG, UK

Objective: To examine the mortality rate and causes of death in a cohort of 300 patients with systemic lupus erythematosus (SLE).

Methods: A retrospective analysis was performed on all patients attending the SLE clinic between 1978 and 2000. Information was obtained on those patients lost to follow up. Cause of death was analysed and categorised as early (<5 years after diagnosis of SLE) and late (>5 years after diagnosis of SLE). Standardised mortality rates were obtained.

Results: The patients were followed up for a median of 8.3 years. Seventy three (24%) patients were no longer followed up at the end of the study period, of whom 41 (14%) had died. Of the 32 patients lost to follow up, 14 were being actively followed up within the UK, 16 were followed up outside the UK, and two patients were untraceable. The most common cause of death was malignancy, which accounted for eight (20%) deaths, followed by infection and vascular disease, which accounted for seven (17%) deaths each.

Conclusions: Malignancy was the most common cause of death. Cause of death varied depending on disease duration. Forty per cent of early deaths were due to SLE related renal disease, whereas 23% of late deaths were due to vascular causes. Death due to infection occurred throughout the follow up period. There was a fourfold increased risk of death in our cohort of patients with SLE compared with the general population.

Keywords: systemic lupus erythematosus; outcome; mortality; prognosis

Abbreviations: APS, antiphospholipid syndrome; SLE, systemic lupus erythematosus; SMR, standardised mortality ratio

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