Predictive factors of mortality in thai systemic lupus erythematosus patients at Sunpasitthiprasong Hospital, Ubonratchathani

Abstract

Background: Systemic Lupus Erythematosus (SLE) is a chronic autoimmune disease thatinvolves multiple organs. The effect of the disease ranges from mild to life-threatening severity.The previous study of prognostic factors of mortality in Thailand is collected in university hospital. However,there has been no studies at a regional medical center level.
Objective: To identify the predictive factors of mortality, overall survival rate, and causes ofdeath of Thai SLE patients at Division of Rheumatology, Department of Internal Medicine,
Sunpasitthiprasong Hospital.
Method: We designed a retrospective cohort study and collected data from medical records ofthe patients who were diagnosed as SLE from January 1st, 2012 to December 31st, 2016. Basic data, diagnostic data and organ involvement, treatment data at first diagnosis and prior to death, and causes of death were collected. SLEDAI-2K score was employed to determine severity of the disease. Cox proportional hazards regression analysis was used to determine predictive factors of mortality.
Results: Of 249 patients, 226 (90.8%) were alive and 23 (9.2%) were dead. The mortality rate of SLE patients was 4.7 cases per 100 person-years. Survival rate at the fourth year of SLE was 84%. Factors associated with mortality included Autoimmune hemolytic anemia [HR = 6.83 (95% CI 1.46 – 31.96) ; P-value = 0.015] , Number of relapse disease per year [HR = 4.55 (95% CI 2.45 – 8.45) ; P -value = < 0.001] and Dyslipidemia [HR = 0.12 (95% CI 0.02 – 0.73) ; P-value = 0.022]. Main cause of death was infection, especially pneumonia (52%).

Conclusion: Predictive factors of mortality are autoimmune hemolytic anemia and number ofrelapse disease per year.
Keywords: Systemic Lupus Erythematosus, predictive factor, cause of death, mortality