A multicentre study of 513 Danish patients with systemic lupus erythematosus. II. Disease mortality and clinical factors of prognostic value

In this Danish multicentre study, predictive clinical factors of mortality and survival were calculated for 513 patients with systemic lupus erythemat osus (SLE). 122 of whom died within a mean observation period of 8.2 years equalling a mortality rate of 2.9% per year. Survival rates were 97%, 91%, 76% and 64% after 1, 5, 10 and 15 years, respectively. The direct causes of death included SLE (n = 35), infections (n = 25), malignancy (n = 9), card iovascular disease (n = 32) and other causes (n = 21). Uni- and multivariat e analyses of survival and mortality were performed for all deaths and for SLE-related deaths. Azotaemia (one-fifth of the patients) was a strong pred ictor of increased overall and SLE-related mortality, but nephropathy per s e (one-half of the patients) and large proteinuria (one-sixth of the patien ts) were unrelated to survival. Haemolytic anaemia had a significant negati ve influence on survival related to mortality caused by infections. Diffuse central nervous system disease and myocarditis were related to increased S LE-related mortality, whereas photosensitivity predicted a decreased mortal ity. Non-fatal infections and thrombotic events predicted a decreased overa ll survival. Since 1980 the mortality caused by SLE manifestations has decr eased significantly.