Risk factors for mortality in 1528 Brazilian childhood-onset systemic lupus erythematosus patients

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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorSAKAMOTO, Ana P.
dc.contributor.authorSILVA, Clovis A.
dc.contributor.authorPITA, Ana C.
dc.contributor.authorTRINDADE, Vitor C.
dc.contributor.authorISLABAO, Aline G.
dc.contributor.authorFIOROT, Fernanda J.
dc.contributor.authorLOPES, Sandra R. M.
dc.contributor.authorPEREIRA, Rosa M. R.
dc.contributor.authorSAAD-MAGALHAES, Claudia
dc.contributor.authorRUSSO, Gleice C. S.
dc.contributor.authorLEN, Claudio A.
dc.contributor.authorPRADO, Rogerio do
dc.contributor.authorCAMPOS, Lucia M. A.
dc.contributor.authorAIKAWA, Nadia E.
dc.contributor.authorAPPENZELLER, Simone
dc.contributor.authorFERRIANI, Virginia P. L.
dc.contributor.authorSILVA, Marco F.
dc.contributor.authorFELIX, Marta
dc.contributor.authorFONSECA, Adriana R.
dc.contributor.authorASSAD, Ana P. L.
dc.contributor.authorSZTAJNBOK, Flavio R.
dc.contributor.authorSANTOS, Maria C.
dc.contributor.authorBICA, Blanca E.
dc.contributor.authorSENA, Evaldo G.
dc.contributor.authorMORAES, Ana J.
dc.contributor.authorFRAGA, Melissa M.
dc.contributor.authorROBAZZI, Teresa C.
dc.contributor.authorSPELLING, Paulo F.
dc.contributor.authorSCHEIBEL, Iloite M.
dc.contributor.authorCAVALCANTI, Andre S.
dc.contributor.authorMATOS, Erica N.
dc.contributor.authorGUIMARAES, Luciano J.
dc.contributor.authorSANTOS, Flavia P.
dc.contributor.authorMOTA, Licia M. H.
dc.contributor.authorBONFA, Eloisa
dc.contributor.authorTERRERI, Maria T.
dc.date.accessioned2024-02-15T14:51:46Z
dc.date.available2024-02-15T14:51:46Z
dc.date.issued2023
dc.description.abstractObjectives: To identify associations between mortality in cSLE patients and their characteristics: clinical and laboratory features, disease activity and damage scores, and treatment; to evaluate risk factors associated with mortality in cSLE; and to determine the most frequent causes of death in this group of patients.Methods: We performed a multicenter retrospective cohort using data from 1,528 cSLE patients followed in 27 pediatric rheumatology tertiary centers in Brazil. Patients' medical records were reviewed according to a standardized protocol, in which information regarding demographic and clinical features, disease activity and damage scores, and treatment were collected and compared between deceased cSLE patients and survivors. Univariate and multivariate analyses by Cox regression model were used to calculate risk factors for mortality, whereas survival rates were analyzed by Kaplan-Meier plots.Results: A total of 63/1,528 (4.1%) patients deceased, 53/63 were female (84.1%), median age at death was 11.9 (9.4-13.1) years and median time interval between cSLE diagnosis and death was 3.2 (0.5-5.3) years. Sepsis was the main cause of death in 27/63 (42.8%) patients, followed by opportunistic infections in 7/63 (11.1%), and alveolar hemorrhage in 6/63 (9.5%) patients. The regression models resulted in neuropsychiatric lupus (NP-SLE) (HR = 2.56, 95% CI = 1.48-4.42) and chronic kidney disease (CKD) (HR = 4.33, 95% CI = 2.33-4.72), as risk factors significantly associated with mortality. Overall patient survival after cSLE diagnosis at 5, 10, and 15 years were 97%, 95.4%, and 93.8%, respectively.Conclusions: This study confirmed that the recent mortality rate in cSLE in Brazil is low, but still of concern. NP-SLE and CKD were the main risk factors for mortality, indicating that the magnitude of these manifestations was significantly high.eng
dc.description.indexMEDLINE
dc.description.indexPubMed
dc.description.indexWoS
dc.description.indexScopus
dc.description.sponsorshipFundacao de Amparo a Pesquisa do Estado de Sao Paulo [2015/03756-4]
dc.description.sponsorshipCoordenacao de Aperfeicoamento de Pessoal de Nivel Superior
dc.description.sponsorshipNucleo de Apoio a Pesquisa ""Saude da Crianca e do Adolescente"" da USP (NAP-CriAd)
dc.description.sponsorshipConselho Nacional de Desenvolvimento Cientifico e Tecnologico [301479/2015-1, 303752/2015-7, 304984/2020-5, 305242/2019-9, 305556/2017-7]
dc.identifier.citationLUPUS, v.32, n.6, p.781-790, 2023
dc.identifier.doi10.1177/09612033231170515
dc.identifier.eissn1477-0962
dc.identifier.issn0961-2033
dc.identifier.urihttps://observatorio.fm.usp.br/handle/OPI/57992
dc.language.isoeng
dc.publisherSAGE PUBLICATIONS LTDeng
dc.relation.ispartofLupus
dc.rightsrestrictedAccesseng
dc.rights.holderCopyright SAGE PUBLICATIONS LTDeng
dc.subjectChildhoodeng
dc.subjectchildhood-onset systemic lupus erythematosuseng
dc.subjectlupus nephritiseng
dc.subjectmortalityeng
dc.subjectsepsiseng
dc.subject.otherneuropsychiatric lupuseng
dc.subject.otherdisease-activityeng
dc.subject.otheradult-onseteng
dc.subject.otherlong-termeng
dc.subject.otherchildreneng
dc.subject.otherrheumatologyeng
dc.subject.otherdamageeng
dc.subject.otherfeatureseng
dc.subject.otherhydroxychloroquineeng
dc.subject.otherclassificationeng
dc.subject.wosRheumatologyeng
dc.titleRisk factors for mortality in 1528 Brazilian childhood-onset systemic lupus erythematosus patientseng
dc.typearticleeng
dc.type.categoryoriginal articleeng
dc.type.versionpublishedVersioneng
dspace.entity.typePublication
hcfmusp.author.externalSAKAMOTO, Ana P.:Univ Fed Sao Paulo, Pediat Rheumatol Unit, Sao Paulo, SP, Brazil; Univ Fed Sao Paulo, Rheumatol Unit, Rua Doutor Bacelar 173,12th Floor, BR-04026000 Sao Paulo, SP, Brazil
hcfmusp.author.externalPITA, Ana C.:Univ Sao Paulo, Fac Med, Pediat Rheumatol Unit, Sao Paulo, Brazil
hcfmusp.author.externalISLABAO, Aline G.:Hosp Crianca Brasilia Jose Alencar, Pediat Rheumatol Unit, Brasilia, DF, Brazil
hcfmusp.author.externalSAAD-MAGALHAES, Claudia:Sao Paulo State Univ UNESP, Fac Med Botucatu, Pediat Rheumatol Div, Botucatu, SP, Brazil
hcfmusp.author.externalRUSSO, Gleice C. S.:Univ Fed Sao Paulo, Pediat Rheumatol Unit, Sao Paulo, SP, Brazil
hcfmusp.author.externalLEN, Claudio A.:Univ Fed Sao Paulo, Pediat Rheumatol Unit, Sao Paulo, SP, Brazil
hcfmusp.author.externalPRADO, Rogerio do:Univ Fed Sao Paulo, Pediat Rheumatol Unit, Sao Paulo, SP, Brazil
hcfmusp.author.externalAPPENZELLER, Simone:Univ Campinas UNICAMP, Sch Med Sci, Dept Orthoped Rheumatol & Traumatol, Campinas, SP, Brazil
hcfmusp.author.externalFERRIANI, Virginia P. L.:Univ Sao Paulo, Ribeirao Preto Med Sch, Pediat Rheumatol Unit, Ribeirao Preto, SP, Brazil
hcfmusp.author.externalSILVA, Marco F.:Hosp Geral Fortaleza, Pediat Rheumatol Unit, Fortaleza, CE, Brazil
hcfmusp.author.externalFELIX, Marta:Univ Fed Rio De Janeiro UFRJ, Pediat Rheumatol Unit, Rio De Janeiro, RJ, Brazil
hcfmusp.author.externalFONSECA, Adriana R.:Univ Fed Rio De Janeiro UFRJ, Pediat Rheumatol Unit, Rio De Janeiro, RJ, Brazil
hcfmusp.author.externalSZTAJNBOK, Flavio R.:Pedro Ernesto Univ Hosp, Pediat Rheumatol Unit, Rio De Janeiro, RJ, Brazil
hcfmusp.author.externalSANTOS, Maria C.:Irmandade Santa Casa Misericordiade Sao Paulo, Pediat Rheumatol Unit, Sao Paulo, SP, Brazil
hcfmusp.author.externalBICA, Blanca E.:Univ Fed Rio De Janeiro, Rheumatol Div, Rio De Janeiro, RJ, Brazil
hcfmusp.author.externalSENA, Evaldo G.:Lauro Vanderley Univ Hosp, Pediat Rheumatol Unit, Joao Pessoa, PB, Brazil
hcfmusp.author.externalMORAES, Ana J.:Fed Univ Para, Pediat Rheumatol Unit, Belem, PA, Brazil
hcfmusp.author.externalFRAGA, Melissa M.:Hosp Darcy Vargas, Pediat Rheumatol Unit, Sao Paulo, SP, Brazil
hcfmusp.author.externalROBAZZI, Teresa C.:Univ Fed Bahia, Pediat Rheumatol Unit, Salvador, BA, Brazil
hcfmusp.author.externalSPELLING, Paulo F.:Hosp Evangel Curitiba, Pediat Rheumatol Unit, Curitiba, PR, Brazil
hcfmusp.author.externalSCHEIBEL, Iloite M.:Hosp Crianca Conceicao, Pediat Rheumatol Unit, Porto Alegre, RS, Brazil
hcfmusp.author.externalCAVALCANTI, Andre S.:Univ Fed Pernambuco, Pediat Rheumatol Unit, Recife, PE, Brazil
hcfmusp.author.externalMATOS, Erica N.:Univ Fed Mato Grosso do Sul, Pediat Rheumatol Unit, Campo Grande, MS, Brazil
hcfmusp.author.externalGUIMARAES, Luciano J.:Univ Brasilia, Pediat Rheumatol Unit, Brasilia, DF, Brazil
hcfmusp.author.externalSANTOS, Flavia P.:Univ Fed Minas Gerais, Pediat Rheumatol Unit, Belo Horizonte, MG, Brazil
hcfmusp.author.externalMOTA, Licia M. H.:Univ Brasilia, Rheumatol Unit, Brasilia, DF, Brazil
hcfmusp.author.externalTERRERI, Maria T.:Univ Fed Sao Paulo, Pediat Rheumatol Unit, Sao Paulo, SP, Brazil
hcfmusp.citation.scopus0
hcfmusp.contributor.author-fmusphcCLOVIS ARTUR ALMEIDA DA SILVA
hcfmusp.contributor.author-fmusphcVITOR CAVALCANTI DA TRINDADE
hcfmusp.contributor.author-fmusphcFERNANDA JUSAN FIOROT
hcfmusp.contributor.author-fmusphcSANDRA REGINA MIYOSHI LOPES
hcfmusp.contributor.author-fmusphcROSA MARIA RODRIGUES PEREIRA
hcfmusp.contributor.author-fmusphcLUCIA MARIA MATTEI DE ARRUDA CAMPOS
hcfmusp.contributor.author-fmusphcNADIA EMI AIKAWA
hcfmusp.contributor.author-fmusphcANA PAULA LUPPINO ASSAD
hcfmusp.contributor.author-fmusphcELOISA SILVA DUTRA DE OLIVEIRA BONFA
hcfmusp.description.beginpage781
hcfmusp.description.endpage790
hcfmusp.description.issue6
hcfmusp.description.volume32
hcfmusp.origemWOS
hcfmusp.origem.pubmed37070932
hcfmusp.origem.scopus2-s2.0-85153118902
hcfmusp.origem.wosWOS:000974161900001
hcfmusp.publisher.cityLONDONeng
hcfmusp.publisher.countryENGLANDeng
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