E Kiss1, N Regéczy, G Szegedi. 1. Third Department of Internal Medicine, Medical University Debrecen, Hungary.
Abstract
OBJECTIVE: Systemic lupus erythematosus survival has improved worldwide. The authors present the first Hungarian survival results, analysing retrospectively data on 532 lupus patients who were followed at a single centre over the past 25 years. RESULTS: Survival of SLE patients has improved in Hungary as indicated by the results of life-table analysis, and the increase in both the five- and ten-year survival rates. The outcome was less favourable for males and for patients under 20 and over 50 years of age at the time of diagnosis. The mortality ratio decreased with disease duration, and the risk of death due to SLE was the highest within the first five years of the disease. The majority of young lupus patients were lost within this period. The mean cause of death was renal insufficiency in the younger patient population and in the early phase of the disease. Heart failure and a naturally increasing mortality rate must be taken into consideration in the patient group over 50 years of age. The prognostic importance of clinical and laboratory symptoms of SLE was determined by the calculation of relative risks. Skin eruptions positively influenced the outcome, while valvular heart disease, interstitial lung disease and haematological manifestations had a negative impact on survival. Surprisingly, renal and central nervous system involvement did not significantly influence survival. The number of patients who were lost to regular follow-up diminished. CONCLUSIONS: The present study indicates an improvement in lupus survival in Hungary. Survival is affected by age and gender differences and may also be influenced by the race and ethnic origin of the patients. Regular follow-up is an important factor in lupus survival.
OBJECTIVE: Systemic lupus erythematosus survival has improved worldwide. The authors present the first Hungarian survival results, analysing retrospectively data on 532 lupuspatients who were followed at a single centre over the past 25 years. RESULTS: Survival of SLEpatients has improved in Hungary as indicated by the results of life-table analysis, and the increase in both the five- and ten-year survival rates. The outcome was less favourable for males and for patients under 20 and over 50 years of age at the time of diagnosis. The mortality ratio decreased with disease duration, and the risk of death due to SLE was the highest within the first five years of the disease. The majority of young lupuspatients were lost within this period. The mean cause of death was renal insufficiency in the younger patient population and in the early phase of the disease. Heart failure and a naturally increasing mortality rate must be taken into consideration in the patient group over 50 years of age. The prognostic importance of clinical and laboratory symptoms of SLE was determined by the calculation of relative risks. Skin eruptions positively influenced the outcome, while valvular heart disease, interstitial lung disease and haematological manifestations had a negative impact on survival. Surprisingly, renal and central nervous system involvement did not significantly influence survival. The number of patients who were lost to regular follow-up diminished. CONCLUSIONS: The present study indicates an improvement in lupus survival in Hungary. Survival is affected by age and gender differences and may also be influenced by the race and ethnic origin of the patients. Regular follow-up is an important factor in lupus survival.
Authors: K Manger; B Manger; R Repp; M Geisselbrecht; A Geiger; A Pfahlberg; T Harrer; J R Kalden Journal: Ann Rheum Dis Date: 2002-12 Impact factor: 19.103