title: Prognostic indicators of hospitalized patients with systemic lupus erythematosus: a large retrospective multicenter study in China.
abstract: OBJECTIVE
  To investigate the mortality of hospitalized patients with systemic lupus erythematosus (SLE) and determine the influential factors associated with poor prognosis.
  
  
  METHODS
  Medical records of 1956 SLE inpatients from 15 hospitals during the period January 1, 1999, to December 31, 2009, were reviewed. All patients were followed up in January 2010. Potential factors associated with mortality were analyzed, comparing patients who were living with those who were deceased. The independency of those factors significantly related to death was determined by Cox regression analysis.
  
  
  RESULTS
  Male to female ratio was 1:15 in this cohort; median age at disease onset was 30 years. Hematologic (70.0%), mucocutaneous (68.2%), musculoskeletal (57.9%), and renal (48.7%) involvements were most often seen in these patients at time of admission. The overall mortality was 8.5% (n = 166), with infection (25.9%), renal failure (19.3%), and neuropsychiatric lupus (18.7%) the leading 3 causes of death. Independent predictors for mortality in this cohort of SLE patients were neuropsychiatric involvement [hazard ratio (HR) 2.19], anemia (HR 1.69), SLEDAI score > 8 at discharge (HR 1.64), increased serum creatinine (HR 1.57), low serum albumin (HR 1.56), cardiopulmonary involvement (HR 1.55), and patient untreated before admission (HR 1.48), whereas the use of antimalarial drugs (HR 0.62) and positive anti-Sm antibody (HR 0.60) were shown to be protective factors.
  
  
  CONCLUSIONS
  SLE patients with delayed treatment and refractory disease have poorer prognosis. A high incidence of death would be expected if they have neuropsychiatric involvement, anemia, azotemia, or cardiopulmonary involvement. Combination therapy with antimalarial drugs may provide some benefit to patients with SLE.
authors: Department of Rheumatology, Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, P.R. China.
authors: Xuebing
authors: X
authors: Feng
authors: Yaohong
authors: Y
authors: Zou
authors: Wenyou
authors: W
authors: Pan
authors: Xiangdang
authors: X
authors: Wang
authors: Min
authors: M
authors: Wu
authors: Miaojia
authors: M
authors: Zhang
authors: Juan
authors: J
authors: Tao
authors: Yu
authors: Y
authors: Zhang
authors: Kuiling
authors: K
authors: Tan
authors: Jin
authors: J
authors: Li
authors: Zhiwei
authors: Z
authors: Chen
authors: Xiang
authors: X
authors: Ding
authors: Xian
authors: X
authors: Qian
authors: Zhanyun
authors: Z
authors: Da
authors: Meimei
authors: M
authors: Wang
authors: Lingyun
authors: L
authors: Sun
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000740:Anemia / Q000150:complications; D053099:Azotemia / Q000150:complications; D002648:Child; D002681:China / Q000453:epidemiology; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007297:Inpatients; D008180:Lupus Erythematosus, Systemic / Q000175:diagnosis* / Q000453:epidemiology / Q000401:mortality*; D020945:Lupus Vasculitis, Central Nervous System / Q000150:complications; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult