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Rheumatology Advance Access originally published online on April 9, 2009
Rheumatology 2009 48(6):673-675; doi:10.1093/rheumatology/kep062
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© The Author 2009. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Damage and mortality in a group of British patients with systemic lupus erythematosus followed up for over 10 years

Sharon A. Chambers1, Elizabeth Allen2, Anisur Rahman1 and David Isenberg1

1Department of Medicine, The Centre for Rheumatology, University College London and 2The London School of Hygiene and Tropical Medicine, London, UK.

Correspondence to: Sharon Chambers, The Centre for Rheumatology, University College London Hospital, 250 Euston Road, 3rd Floor Central, London NW1 2PQ, UK. E-mail: shrspk{at}aol.com


  Abstract

Objective. To study damage accrual and mortality in British patients with SLE under long-term follow-up for >10 years.

Methods. We analysed the clinical records of 232 patients with SLE who had at least 10 years of consistent follow-up at University College London Hospital (UCLH). We noted their SLICC/ACR Damage Index (SDI) scores and category of damage at 1 year post-diagnosis of SLE and every 5 years thereafter. For patients who had died, we determined the year and cause of death.

Results. Ninety per cent of patients had no damage at 1 year post-diagnosis of SLE; however by year 10, 50% had accrued some damage. Damage accrual was mostly in the neuropsychiatric, renal and musculoskeletal categories. An increase in damage score was associated with a higher risk of death overall. Forty-four patients died during the period of follow-up. Sepsis, cancer and organ failure (cardiac, renal and liver) were the main causes of death in this group of patients.

Conclusions. Damage accrual is associated with an increased risk of mortality. Infections remain an important cause of death in patients with SLE.

KEY WORDS: Damage, Mortality, SLICC/ACR, SLE, Survival, Sepsis, Cancer, UK, Multiethnic, Musculoskeletal

Submitted 30 July 2008; revised version accepted 26 February 2009.
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