FACTORS AFFECTING MORTALITY OF PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS (PROSPECTIVE STUDY)

Abstract

Introduction. Systemic lupus erythematosus is accompanied by lesions in vital organs and systems and significantly reduces the life expectancy of patients. Attempts have been made to identify the main factors that worsen the prognosis of patients and increase the risk of mortality. The obtained information has often been fragmentary, taking account of only a few factors, and sometimes contradictory.
Objective. To identify factors that affect the mortality of patients with systemic lupus erythematosus.
Materials and methods. 294 patients after stratification by the presence of systemic lupus erythematosus were randomly enrolled in a prospective study. The study was conducted in two phases. The first phase consisted of three consecutive steps. At the first step we analyzed passport data, at the second step – the presence of ACR criteria, and at the third step – the presence of pathogenetically associated with SLE organ lesions. In general, the first phase dealt with the analysis of factors that determine the survival of patients with SLE. The purpose of the second phase was to identify constellations of manifestations that most significantly determine the risk of death.
Results. Factors that increase the mortality of patients with SLE are male sex, age (under 42.5 years), proteinuria and cylindruria, seizures, lymphopenia, lupus anticoagulant antibodies, as well as the presence of myocarditis, pneumonitis, autoimmune hepatitis, aseptic necrosis, chronic caries. However, the combination of male sex, overweight (over 92.5 kg) and autoimmune hepatitis plays the most important role.