Conference paper

CAUSES OF EARLY AND LATE DEATH AND SURVIVAL OF SLE PATIENTS OVER A 10-YEAR PERIOD: ANALYSIS FROM A CROATIAN TERTIARY CENTER

Ivan Padjen ; Division of Clinical Immunology and Rheumatology, Department of Internal Medicine, University Hospital Centre Zagreb and University of Zagreb, School of Medicine, Zagreb, Croatia;
Mislav Cerovec ; Division of Clinical Immunology and Rheumatology, Department of Internal Medicine, University Hospital Centre Zagreb and University of Zagreb, School of Medicine, Zagreb, Croatia;
Miroslav Mayer ; Division of Clinical Immunology and Rheumatology, Department of Internal Medicine, University Hospital Centre Zagreb and University of Zagreb, School of Medicine, Zagreb, Croatia;
Marko Barešić ; Division of Clinical Immunology and Rheumatology, Department of Internal Medicine, University Hospital Centre Zagreb and University of Zagreb, School of Medicine, Zagreb, Croatia;
Dubravka Bosnić ; Division of Clinical Immunology and Rheumatology, Department of Internal Medicine, University Hospital Centre Zagreb and University of Zagreb, School of Medicine, Zagreb, Croatia;
Mirna Sentić ; Division of Clinical Immunology and Rheumatology, Department of Internal Medicine, University Hospital Centre Zagreb and University of Zagreb, School of Medicine, Zagreb, Croatia;
Marijan Erceg ; Croatian Institute of Public Health, Zagreb, Croatia
Ranko Stevanović ; Croatian Institute of Public Health, Zagreb, Croatia
Branimir Anić ; Division of Clinical Immunology and Rheumatology, Department of Internal Medicine, University Hospital Centre Zagreb and University of Zagreb, School of Medicine, Zagreb, Croatia;

Abstract

Background: Causes of death (CODs) and survival serve as indicators of overall care of SLE patients. While most of the available data on CODs and survival originate from highly developed healthcare settings and dedicated lupus cohorts, data from Croatia and neighboring countries are still lacking.
Objectives: Retrospective analysis of disease features and CODs of SLE patients deceased from 2002 to 2011; assessment of survival of patients diagnosed over the same period. Methods: We analyzed features of 90 patients followed-up at our center, who deceased over the 2002–2011 period. Early death (ED) was defined as death occuring within 5 (10) years following diagnosis, while late death (LD) was defined as death occuring thereaft er. An extensive set of variables was compared between the ED and LD groups: demographics, ACR classification criteria, damage and causes of death. We also analyzed survival in a retrospective cohort of 213 patients.
Results: Among 90 deceased patients (68 females), mean age at death was 58±15 years. Th e most frequent classification criteria were antinuclear antibodies (96%), immunological (92%) and hematological disorder (83%), with no difference between the ED and LD groups. 85/90 (94%) patients accrued organ damage, most frequently in the musculoskeletal (59%), cardiovascular (51%) and neuropsychiatric (NP) (48%) domains. Th e most frequent CODs were cardiovascular diseases (40%), followed by infections (33%), active SLE (29%) and malignancies (17%). Th ere was no difference between the frequencies of CODs, except for stroke, which caused death exclusively ≥10 years aft er diagnosis. SLE was recorded in death certificates of 41/90 patients. Five- and ten-year survival in the retrospective cohort (185 non-deceased, 28 deceased patients) was 91% and 80.5%, respectively. NP and renal disorder, serositis and later-onset disease were identified as predictors of death. Conclusions: Five-year survival >90% is in line with survival rates observed in developed countries, while tenyear survival is lower. Th e contribution of SLE to death seems to be underrecognized in SLE patients’ death certificates.
References:
1. Padjen I et al. Croat Med J. 2018;59:3–12.
2. Calvo-Alen J et al. Rheumatology 2005;44:1186–9.

Keywords

Hrčak ID:

210514

URI

https://hrcak.srce.hr/210514

Publication date:

5.12.2018.

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