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

Rheumatology (Oxford). 2009 Jun;48(6):673-5. doi: 10.1093/rheumatology/kep062. Epub 2009 Apr 9.


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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cause of Death
  • Disease Progression
  • Female
  • Follow-Up Studies
  • Humans
  • Kidney Diseases / complications
  • Kidney Diseases / mortality
  • Kidney Diseases / pathology
  • Lung Diseases / complications
  • Lung Diseases / mortality
  • Lung Diseases / pathology
  • Lupus Erythematosus, Systemic / mortality*
  • Lupus Erythematosus, Systemic / pathology
  • Lupus Erythematosus, Systemic / therapy
  • Male
  • Musculoskeletal Diseases / complications
  • Musculoskeletal Diseases / mortality
  • Musculoskeletal Diseases / pathology
  • Neoplasms / complications
  • Neoplasms / mortality
  • Neoplasms / pathology
  • Proportional Hazards Models
  • Skin Diseases / complications
  • Skin Diseases / mortality
  • Skin Diseases / pathology
  • Stroke / complications
  • Stroke / mortality
  • Stroke / pathology
  • Time Factors
  • United Kingdom