Systemic lupus erythematosus: mortality and survival in Argentina. A multicenter study.
OBJECTIVE
To analyze the factors associated with mortality, survival and causes of death in patients with systemic lupus erythematosus (SLE) in Argentina.


METHODS
A series of 366 patients with SLE (45 men and 321 women), mean age 29 y (range 11-70 y) and mean disease duration 6 y, was evaluated from 1990 to 1998. A total of 57 clinical, serological and therapeutic variables were studied.


RESULTS
Five- and 10-year survival was 91% and 85% respectively. Forty four patients died (12%): 54% due to sepsis and 32% due to active SLE. Mortality risk factors included heart involvement CRR 3.82), hyperlipidemia (RR 2.72), renal damage (RR 2. 62), infections (RR 2.44), lung disease (RR 2.20) and myositis (RR 2. 07). High-dose prednisone (RR 3.4) or cyclophosphamide (RR 9.19) treatments increased the risk of sepsis (P=0.003) as a cause of death. However, corticosteroids, antimalarial agents and accumulated cyclophosphamide doses proved to be protective factors in overall mortality figures (RR <1).


CONCLUSIONS
The main risk factors of death in SLE were heart involvement, hyperlipidemia and renal damage. Treatment with steroids, antimalarial agents and cyclophosphamide improved survival. High-dose corticosteroids and cyclophosphamide were associated with sepsis as a cause of death.
Bellomio
V
V
Posgrado de Reumatología, Universidad Nacional de Tucumán, Argentina.
Spindler
A
A
Lucero
E
E
Berman
A
A
Santana
M
M
Moreno
C
C
Hidalgo
R P
RP
Paira
S
S
Graf
C
C
Maldonado Cocco
J A
JA
Citera
G
G
Arriola
M S
MS
Gómez
G
G
Barreira
J C
JC
Messina
O
O
Asnal
C
C
Carrillo
D
D
Gervilla
A
A
García
L
L
Máscolo
M
M
De la Sota M
D
D
Rosso
G
G
Somma
L F
LF
Sosa
R F
RF
Rillo
O
O
Caracciolo
J A
JA
Lancioni
G
G
Gómez
A
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D001118:Argentina / Q000453:epidemiology; D002648:Child; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D016019:Survival Analysis