Background/Purpose: To study the mortality, survival and causes of death in a Spanish cohort of patients with systemic lupus erythematosus (SLE) over a 28-year period (1985-2013).

Methods: The sample comprised 219 patients with SLE treated between 1985 and 2013 at a tertiary university hospital that does not attend pediatric populations. Patients were registered in a specific database. Survival over time was studied by the Kaplan-Meier method. For patients who died or were lost to follow-up, data were censored at the last clinical visit.

Results: Mean age at diagnosis of SLE of the 219 patients recruited (189 women) was 46 ± 14 years, and mean follow-up was 8.47 ± 4.12 yrs (58% of patients were followed ≥ 10 yrs and 43% < 10 yrs).

During follow-up, 14 patients (6%) died: five due to cardiovascular disease, four of cancer, four due to infection (one invasive pulmonary aspergillosis, one Pneumocystis jirovecii pneumonia, one necrotizing fasciitis, and one Pseudomonas aeruginosa-induced sepsis), and one due to SLE activity.

The median time from diagnosis of disease to death was 106 months in patients who died of cardiovascular disease, 185 months in cases of infection, and 206.5 months in patients with cancer. Cumulative survival from onset was 99% at 5 years (95% CI 0.977-1.000), 97.6% at 10 years (0.954-1.000), 93% at 15 years (0.885-0.977), 87.8% at 20 years (0.808-0.953) and 82.1% (0.726-0.930) at 25 years. Overall mortality rate increased from 2005 to 2013. The mean age at death increased with time.

Conclusion: Long-term survival in a series of Spanish patients with SLE was high, with a cumulative survival from diagnosis of 97.6% at 10 years and 87.8% at 20 years. Cardiovascular disease (35%), infections (29%) and cancer (29%) represented the main causes of death.

ACR Meeting Abstracts - https://acrabstracts.org/abstract/mortality-and-survival-in-systemic-lupus-erythematosus-patients-trends-in-a-spanish-cohort-from-1985-to-2013/