MORTALITY STUDIES IN SYSTEMIC LUPUS-ERYTHEMATOSUS - RESULTS FROM A SINGLE-CENTER .1. CAUSES OF DEATH

Objective. To study the causes of death in patients with SLE, followed prospectively in a single center. Methods. The study population compr ised 665 patients with systemic lupus erythematosus (SLE). Causes of d eath were determined by review of hospital files, autopsy reports, and death certificates. Nonparametric lifetable models were used to calcu late Kaplan-Meier estimates of survival probabilities. Results. One hu ndred and twenty-four patients (18.6%) had died. The primary causes of death were active SLE in 20 (16%), infection in 40 (32%), acute vascu lar event in 19 (15.4%), sudden death in 10 (8.1%), organ failure in 6 (4.8%), malignancy in 8 (6.5%), others in 8 (6.5%), and unknown in 13 (10.5%). Death as a result of active SLE was more common in patients who died within 5 years of diagnosis compared to those dying after 5 y ears (p = 0.021), and deaths due to vascular, events and end organ fai lure not related to active lupus were more frequent in the late death group (p = 0.028). The overall 5, 10, 15, and 20 year survival rates w ere 93, 85, 79, and 68%, respectively. Patients with SLE had a 4.92 fo ld increased risk for death compared with the general population.Concl usion. Survival rates continue to improve in SLE but causes of mortali ty vary at different stages.