MORTALITY RISKS ASSOCIATED WITH SPECIFIC CLINICAL MANIFESTATIONS OF SYSTEMIC LUPUS-ERYTHEMATOSUS

Background: Mortality in patients with systemic lupus erythematosus (S LE) is often related to disease in particular organ systems. We examin ed the risks of mortality associated with 8 clinical manifestations of SLE and determined whether these risks differed among patients with d ifferent sociodemographic characteristics. Methods: Using life table a nalysis, we determined the associations of hemolytic anemia, leukopeni a, thrombocytopenia, arthritis, serositis, nephritis, psychosis, and s eizures with both all-cause mortality and SLE-related mortality in a c ohort of 408 patients. Results: Over a median duration of follow-up of 11 years, 144 patients died; 78 deaths (54%) were SLE related. In uni variate analyses, the presence of hemolytic anemia, serositis, nephrit is, psychosis, and seizures was associated with greater all-cause mort ality, while the presence of arthritis was protective. In multivariate analyses that controlled for patient demographic characteristics, nep hritis (relative risk, 2.34) and seizures (relative risk, 1.77) were a ssociated with poorer overall survival. Nephritis and seizures, along with thrombocytopenia, were also associated with greater SLE-related m ortality, while leukopenia was protective. The risk of death in associ ation with these clinical manifestations did not differ among patient age, sex, race, or socioeconomic subgroups. Conclusions: The presence of nephritis and seizures each increased the risk of death in patients with SIE approximately 2-fold. Thrombocytopenia also increased the ri sk of SLE-related mortality, while leukopenia was protective.