title: Mortality associated with systemic lupus erythematosus in France assessed by multiple-cause-of-death analysis.
abstract: OBJECTIVE
  To assess the mortality profile of systemic lupus erythematosus (SLE) patients in France using multiple-cause-of-death analysis.
  
  
  METHODS
  Data were collected between 2000 and 2009 in the French Epidemiological Center for the Medical Causes of Death database, and death certificates issued upon the death of an adult for whom SLE was an underlying cause of death (UCD) or a non-underlying cause of death (NUCD) were evaluated using multiple-cause-of-death analysis. Sex, age, sex ratio, standardized mortality rates, as well as frequency of the various causes of death were assessed, at both a national and a regional level. For the main causes of death, the observed number of deaths in relation to the expected number of deaths (O:E ratio) (standardized for age and sex) was calculated.
  
  
  RESULTS
  During the study period, 1,593 deaths related to SLE were identified. The mean ± SD age at death was 63.5 ± 18.4 years and the sex ratio (female:male) was 3.5. The mean standardized mortality rate was 3.2 per 1 million people (range 2.7-4.1). When SLE was the UCD (n = 637), the main NUCDs were cardiovascular diseases (49.5%), infectious diseases (24.5%), and renal failure (23.2%). When SLE was an NUCD (n = 956), the most common UCDs were cardiovascular diseases (35.7%), neoplasms (13.9%), and infectious diseases (10.3%). The overall O:E ratio was >1 for infectious and cardiovascular diseases and renal failure (especially among people <40 years of age for the latter 2 causes), but was <1 for neoplasms.
  
  
  CONCLUSIONS
  Cardiovascular disease is the leading cause of death associated with SLE in France.
authors.affiliation: Hôpital de la Conception, AP-HM, and Université Aix-Marseille, Marseille, France.
authors.forename: Guillemette
authors.initials: G
authors.lastname: Thomas
authors.forename: Julien
authors.initials: J
authors.lastname: Mancini
authors.forename: Noémie
authors.initials: N
authors.lastname: Jourde-Chiche
authors.forename: Gabrielle
authors.initials: G
authors.lastname: Sarlon
authors.forename: Zahir
authors.initials: Z
authors.lastname: Amoura
authors.forename: Jean-Robert
authors.initials: JR
authors.lastname: Harlé
authors.forename: Eric
authors.initials: E
authors.lastname: Jougla
authors.forename: Laurent
authors.initials: L
authors.lastname: Chiche
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000401:mortality*; D002423:Cause of Death; D003644:Death Certificates; D005260:Female; D005602:France; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D009026:Mortality; D044465:White People