Cargando…

Comparison of Contributors to Mortality Differences in SLE Patients with Different Initial Disease Activity: A Larger Multicenter Cohort Study

To explore the etiology of risk factors and quantify the mortality differences in systemic lupus erythematosus (SLE) patients with different initial disease activity. The Jiangsu Lupus database was established by collecting medical records from first-hospitalized SLE patients during 1999–2009 from 2...

Descripción completa

Detalles Bibliográficos
Autores principales: Jin, Ziyi, Chen, Zheng, Pan, Wenyou, Liu, Lin, Wu, Min, Hu, Huaixia, Ding, Xiang, Wei, Hua, Zou, Yaohong, Qian, Xian, Wang, Meimei, Wu, Jian, Tao, Juan, Tan, Jun, Da, Zhanyun, Zhang, Miaojia, Li, Jing, Feng, Xuebing, Sun, Lingyun
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9918091/
https://www.ncbi.nlm.nih.gov/pubmed/36769709
http://dx.doi.org/10.3390/jcm12031061
_version_ 1784886526692294656
author Jin, Ziyi
Chen, Zheng
Pan, Wenyou
Liu, Lin
Wu, Min
Hu, Huaixia
Ding, Xiang
Wei, Hua
Zou, Yaohong
Qian, Xian
Wang, Meimei
Wu, Jian
Tao, Juan
Tan, Jun
Da, Zhanyun
Zhang, Miaojia
Li, Jing
Feng, Xuebing
Sun, Lingyun
author_facet Jin, Ziyi
Chen, Zheng
Pan, Wenyou
Liu, Lin
Wu, Min
Hu, Huaixia
Ding, Xiang
Wei, Hua
Zou, Yaohong
Qian, Xian
Wang, Meimei
Wu, Jian
Tao, Juan
Tan, Jun
Da, Zhanyun
Zhang, Miaojia
Li, Jing
Feng, Xuebing
Sun, Lingyun
author_sort Jin, Ziyi
collection PubMed
description To explore the etiology of risk factors and quantify the mortality differences in systemic lupus erythematosus (SLE) patients with different initial disease activity. The Jiangsu Lupus database was established by collecting medical records from first-hospitalized SLE patients during 1999–2009 from 26 centers in Jiangsu province, China, and their survival status every five years. The initial SLEDAI scores [high (>12) vs. low–moderate (≤12)] differences in mortality attributable to risk factors were quantified using population attributable fraction (PAF), relative attributable risk (RAR) and adjusted relative risk (ARR). Among 2446 SLE patients, 83 and 176 deaths were observed in the low–moderate and high activity groups, with mortality rates of 7.7 and 14.0 per 1000 person years, respectively. Anemia was the leading contributor to mortality, with PAFs of 40.4 and 37.5 in the low–moderate and high activity groups, respectively, and explained 23.2% of the mortality differences with an ARR of 1.66 between the two groups. Cardiopulmonary involvement caused the highest PAFs in the low–moderate (20.5%) and high activity (13.6%) groups, explaining 18.3% of the mortality differences. The combination of anemia and cardiopulmonary involvement had the highest RAR, causing 39.8% of the mortality differences (ARR = 1.52) between the two groups. In addition, hypoalbuminemia and a decrease in the creatinine clearance rate accounted for 20–30% of deaths and explained 10–20% of the mortality differences between the two groups, while antimalarial drug nonuse accounted for about 35% of deaths and explained 3.6% of the mortality differences. Anemia, cardiopulmonary involvement and hypoalbuminemia may cause substantial mortality differences across disease activity states, suggesting additional strategies beyond disease activity assessment to monitor SLE outcomes.
format Online
Article
Text
id pubmed-9918091
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-99180912023-02-11 Comparison of Contributors to Mortality Differences in SLE Patients with Different Initial Disease Activity: A Larger Multicenter Cohort Study Jin, Ziyi Chen, Zheng Pan, Wenyou Liu, Lin Wu, Min Hu, Huaixia Ding, Xiang Wei, Hua Zou, Yaohong Qian, Xian Wang, Meimei Wu, Jian Tao, Juan Tan, Jun Da, Zhanyun Zhang, Miaojia Li, Jing Feng, Xuebing Sun, Lingyun J Clin Med Article To explore the etiology of risk factors and quantify the mortality differences in systemic lupus erythematosus (SLE) patients with different initial disease activity. The Jiangsu Lupus database was established by collecting medical records from first-hospitalized SLE patients during 1999–2009 from 26 centers in Jiangsu province, China, and their survival status every five years. The initial SLEDAI scores [high (>12) vs. low–moderate (≤12)] differences in mortality attributable to risk factors were quantified using population attributable fraction (PAF), relative attributable risk (RAR) and adjusted relative risk (ARR). Among 2446 SLE patients, 83 and 176 deaths were observed in the low–moderate and high activity groups, with mortality rates of 7.7 and 14.0 per 1000 person years, respectively. Anemia was the leading contributor to mortality, with PAFs of 40.4 and 37.5 in the low–moderate and high activity groups, respectively, and explained 23.2% of the mortality differences with an ARR of 1.66 between the two groups. Cardiopulmonary involvement caused the highest PAFs in the low–moderate (20.5%) and high activity (13.6%) groups, explaining 18.3% of the mortality differences. The combination of anemia and cardiopulmonary involvement had the highest RAR, causing 39.8% of the mortality differences (ARR = 1.52) between the two groups. In addition, hypoalbuminemia and a decrease in the creatinine clearance rate accounted for 20–30% of deaths and explained 10–20% of the mortality differences between the two groups, while antimalarial drug nonuse accounted for about 35% of deaths and explained 3.6% of the mortality differences. Anemia, cardiopulmonary involvement and hypoalbuminemia may cause substantial mortality differences across disease activity states, suggesting additional strategies beyond disease activity assessment to monitor SLE outcomes. MDPI 2023-01-30 /pmc/articles/PMC9918091/ /pubmed/36769709 http://dx.doi.org/10.3390/jcm12031061 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Jin, Ziyi
Chen, Zheng
Pan, Wenyou
Liu, Lin
Wu, Min
Hu, Huaixia
Ding, Xiang
Wei, Hua
Zou, Yaohong
Qian, Xian
Wang, Meimei
Wu, Jian
Tao, Juan
Tan, Jun
Da, Zhanyun
Zhang, Miaojia
Li, Jing
Feng, Xuebing
Sun, Lingyun
Comparison of Contributors to Mortality Differences in SLE Patients with Different Initial Disease Activity: A Larger Multicenter Cohort Study
title Comparison of Contributors to Mortality Differences in SLE Patients with Different Initial Disease Activity: A Larger Multicenter Cohort Study
title_full Comparison of Contributors to Mortality Differences in SLE Patients with Different Initial Disease Activity: A Larger Multicenter Cohort Study
title_fullStr Comparison of Contributors to Mortality Differences in SLE Patients with Different Initial Disease Activity: A Larger Multicenter Cohort Study
title_full_unstemmed Comparison of Contributors to Mortality Differences in SLE Patients with Different Initial Disease Activity: A Larger Multicenter Cohort Study
title_short Comparison of Contributors to Mortality Differences in SLE Patients with Different Initial Disease Activity: A Larger Multicenter Cohort Study
title_sort comparison of contributors to mortality differences in sle patients with different initial disease activity: a larger multicenter cohort study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9918091/
https://www.ncbi.nlm.nih.gov/pubmed/36769709
http://dx.doi.org/10.3390/jcm12031061
work_keys_str_mv AT jinziyi comparisonofcontributorstomortalitydifferencesinslepatientswithdifferentinitialdiseaseactivityalargermulticentercohortstudy
AT chenzheng comparisonofcontributorstomortalitydifferencesinslepatientswithdifferentinitialdiseaseactivityalargermulticentercohortstudy
AT panwenyou comparisonofcontributorstomortalitydifferencesinslepatientswithdifferentinitialdiseaseactivityalargermulticentercohortstudy
AT liulin comparisonofcontributorstomortalitydifferencesinslepatientswithdifferentinitialdiseaseactivityalargermulticentercohortstudy
AT wumin comparisonofcontributorstomortalitydifferencesinslepatientswithdifferentinitialdiseaseactivityalargermulticentercohortstudy
AT huhuaixia comparisonofcontributorstomortalitydifferencesinslepatientswithdifferentinitialdiseaseactivityalargermulticentercohortstudy
AT dingxiang comparisonofcontributorstomortalitydifferencesinslepatientswithdifferentinitialdiseaseactivityalargermulticentercohortstudy
AT weihua comparisonofcontributorstomortalitydifferencesinslepatientswithdifferentinitialdiseaseactivityalargermulticentercohortstudy
AT zouyaohong comparisonofcontributorstomortalitydifferencesinslepatientswithdifferentinitialdiseaseactivityalargermulticentercohortstudy
AT qianxian comparisonofcontributorstomortalitydifferencesinslepatientswithdifferentinitialdiseaseactivityalargermulticentercohortstudy
AT wangmeimei comparisonofcontributorstomortalitydifferencesinslepatientswithdifferentinitialdiseaseactivityalargermulticentercohortstudy
AT wujian comparisonofcontributorstomortalitydifferencesinslepatientswithdifferentinitialdiseaseactivityalargermulticentercohortstudy
AT taojuan comparisonofcontributorstomortalitydifferencesinslepatientswithdifferentinitialdiseaseactivityalargermulticentercohortstudy
AT tanjun comparisonofcontributorstomortalitydifferencesinslepatientswithdifferentinitialdiseaseactivityalargermulticentercohortstudy
AT dazhanyun comparisonofcontributorstomortalitydifferencesinslepatientswithdifferentinitialdiseaseactivityalargermulticentercohortstudy
AT zhangmiaojia comparisonofcontributorstomortalitydifferencesinslepatientswithdifferentinitialdiseaseactivityalargermulticentercohortstudy
AT lijing comparisonofcontributorstomortalitydifferencesinslepatientswithdifferentinitialdiseaseactivityalargermulticentercohortstudy
AT fengxuebing comparisonofcontributorstomortalitydifferencesinslepatientswithdifferentinitialdiseaseactivityalargermulticentercohortstudy
AT sunlingyun comparisonofcontributorstomortalitydifferencesinslepatientswithdifferentinitialdiseaseactivityalargermulticentercohortstudy