Damage and mortality in a group of British patients with systemic lupus erythematosus followed up for over 10 years.
OBJECTIVE
To study damage accrual and mortality in British patients with SLE under long-term follow-up for >10 years.


METHODS
We analysed the clinical records of 232 patients with SLE who had at least 10 years of consistent follow-up at University College London Hospital (UCLH). We noted their SLICC/ACR Damage Index (SDI) scores and category of damage at 1 year post-diagnosis of SLE and every 5 years thereafter. For patients who had died, we determined the year and cause of death.


RESULTS
Ninety per cent of patients had no damage at 1 year post-diagnosis of SLE; however by year 10, 50% had accrued some damage. Damage accrual was mostly in the neuropsychiatric, renal and musculoskeletal categories. An increase in damage score was associated with a higher risk of death overall. Forty-four patients died during the period of follow-up. Sepsis, cancer and organ failure (cardiac, renal and liver) were the main causes of death in this group of patients.


CONCLUSIONS
Damage accrual is associated with an increased risk of mortality. Infections remain an important cause of death in patients with SLE.
Department of Medicine, The Centre for Rheumatology, University College London, London, UK. shrspk@aol.com
Sharon A
SA
Chambers
Elizabeth
E
Allen
Anisur
A
Rahman
David
D
Isenberg
D000328:Adult; D002423:Cause of Death; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007674:Kidney Diseases / Q000150:complications / Q000401:mortality / Q000473:pathology; D008171:Lung Diseases / Q000150:complications / Q000401:mortality / Q000473:pathology; D008180:Lupus Erythematosus, Systemic / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D008297:Male; D009140:Musculoskeletal Diseases / Q000150:complications / Q000401:mortality / Q000473:pathology; D009369:Neoplasms / Q000150:complications / Q000401:mortality / Q000473:pathology; D016016:Proportional Hazards Models; D012871:Skin Diseases / Q000150:complications / Q000401:mortality / Q000473:pathology; D020521:Stroke / Q000150:complications / Q000401:mortality / Q000473:pathology; D013997:Time Factors; D006113:United Kingdom