Risk factors for mortality in 1528 Brazilian childhood-onset systemic lupus erythematosus patients
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Citações na Scopus
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Tipo de produção
article
Data de publicação
2023
Título da Revista
ISSN da Revista
Título do Volume
Editora
SAGE PUBLICATIONS LTD
Autores
SAKAMOTO, Ana P.
PITA, Ana C.
ISLABAO, Aline G.
SAAD-MAGALHAES, Claudia
RUSSO, Gleice C. S.
Citação
LUPUS, v.32, n.6, p.781-790, 2023
Resumo
Objectives: 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.
Palavras-chave
Childhood, childhood-onset systemic lupus erythematosus, lupus nephritis, mortality, sepsis
Referências
- Abujam B, 2016, CLIN EXP RHEUMATOL, V34, P554
- Aggarwal A, 2018, LUPUS, V27, P1867, DOI 10.1177/0961203318791046
- Aguirre-Valencia D, 2019, AUTOIMMUN DIS, V2019, DOI 10.1155/2019/5350960
- [Anonymous], 2007, DECL OB DOC NEC IMP
- Aytaç S, 2016, RHEUMATOL INT, V36, P1421, DOI 10.1007/s00296-016-3545-9
- Benseler SM, 2007, LUPUS, V16, P564, DOI 10.1177/0961203307078971
- Chiewthanakul P, 2012, ASIAN PAC J ALLERGY, V30, P55
- Chighizola CB, 2017, CLIN REV ALLERG IMMU, V52, P401, DOI 10.1007/s12016-016-8582-3
- Medeiros MMD, 2016, LUPUS, V25, P355, DOI 10.1177/0961203315606983
- Santos ACEZ, 2019, REV INST MED TROP SP, V61, DOI [10.1590/S1678-9946201961039, 10.1590/s1678-9946201961039]
- Faco MMM, 2007, BRAZ J MED BIOL RES, V40, P993, DOI 10.1590/S0100-879X2006005000110
- Fatemi A, 2017, CLIN RHEUMATOL, V36, P343, DOI 10.1007/s10067-016-3509-1
- Gladman D, 1996, ARTHRITIS RHEUM, V39, P363, DOI 10.1002/art.1780390303
- Gladman DD, 2002, J RHEUMATOL, V29, P288
- GOLDMAN L, 1983, NEW ENGL J MED, V308, P1000, DOI 10.1056/NEJM198304283081704
- Gomes RC, 2016, ARTHRIT CARE RES, V68, P1736, DOI 10.1002/acr.22881
- Groot N, 2019, ARTHRITIS RHEUMATOL, V71, P290, DOI 10.1002/art.40697
- Hochberg MC, 1997, ARTHRITIS RHEUM, V40, P1725, DOI 10.1002/art.1780400928
- Jongvilaikasem P, 2018, PEDIATR RHEUMATOL, V16, DOI 10.1186/s12969-018-0274-5
- Kamphuis S, 2010, NAT REV RHEUMATOL, V6, P538, DOI 10.1038/nrrheum.2010.121
- Khajezadeh MA, 2018, NEUROL RES INT, V2018, DOI 10.1155/2018/2548142
- Khandelwal P, 2023, PEDIATR NEPHROL, V38, P987, DOI 10.1007/s00467-022-05769-x
- Levy DM, 2012, PEDIATR CLIN N AM, V59, P345, DOI 10.1016/j.pcl.2012.03.007
- Liang MH, 1999, ARTHRITIS RHEUM-US, V42, P599
- Lim LSH, 2017, ARTHRIT CARE RES, V69, P1627, DOI 10.1002/acr.23199
- Lopes SRM, 2017, LUPUS, V26, P996, DOI 10.1177/0961203317690616
- Mahmoud GA, 2018, LUPUS, V27, P1562, DOI 10.1177/0961203318776085
- Malattia C, 2013, BEST PRACT RES CL RH, V27, P351, DOI 10.1016/j.berh.2013.07.007
- Mina R, 2010, RHEUM DIS CLIN N AM, V36, P53, DOI 10.1016/j.rdc.2009.12.012
- Mok CC, 2018, LUPUS, V27, P722, DOI 10.1177/0961203317739129
- Nieto-Aristizábal I, 2019, LUPUS, V28, P1566, DOI 10.1177/0961203319883680
- Novak GV, 2018, LUPUS, V27, P1712, DOI 10.1177/0961203318787037
- Pagnoux C, 2005, LUPUS, V14, P871, DOI 10.1191/0961203305lu2174rr
- Petri M, 2012, ARTHRITIS RHEUM-US, V64, P2677, DOI 10.1002/art.34473
- Pons-Estel GJ, 2009, ARTHRIT RHEUM-ARTHR, V61, P830, DOI 10.1002/art.24538
- Ramos GF, 2019, J PEDIAT-BRAZIL, V95, P667, DOI 10.1016/j.jped.2018.06.006
- Rubinstein TB, 2020, RHEUM DIS CLIN N AM, V46, P661, DOI 10.1016/j.rdc.2020.07.007
- Sahin S, 2018, LUPUS, V27, P514, DOI 10.1177/0961203317747717
- Sakthiswary R, 2014, MEDICINE, V93, DOI 10.1097/MD.0000000000000086
- Silva CA, 2012, ARTHRIT CARE RES, V64, P1787, DOI 10.1002/acr.21757
- Silva CA, 2016, EXPERT REV CLIN IMMU, V12, P907, DOI 10.1080/1744666X.2016.1195685
- Tarr T, 2015, LUPUS, V24, P796, DOI 10.1177/0961203314563817
- Tavangar-Rad F, 2014, IRAN J PEDIATR, V24, P365
- Tektonidou MG, 2017, ANN RHEUM DIS, V76, P2009, DOI 10.1136/annrheumdis-2017-211663
- Tektonidou MG, 2015, ARTHRIT CARE RES, V67, P1078, DOI 10.1002/acr.22575
- Torrente-Segarra V., 2018, SOC PETR ENG KINGD S, V0, P1, DOI 10.2118/192289-MS
- Tsakonas E, 1998, LUPUS, V7, P80
- Urowitz MB, 2008, J RHEUMATOL, V35, P2152, DOI 10.3899/jrheum.080214
- Vachvanichsanong P, 2011, ARCH DIS CHILD, V96, P44, DOI 10.1136/adc.2010.183699
- Vyas S, 2002, PEDIATR NEPHROL, V17, P45, DOI 10.1007/s004670200008
Coleções
Artigos e Materiais de Revistas Científicas - FM/MPE
Artigos e Materiais de Revistas Científicas - FM/MCM
Artigos e Materiais de Revistas Científicas - HC/ICHC
Artigos e Materiais de Revistas Científicas - HC/ICr
Artigos e Materiais de Revistas Científicas - HC/InCor
Artigos e Materiais de Revistas Científicas - LIM/17
Carregar mais Artigos e Materiais de Revistas Científicas - FM/MCM
Artigos e Materiais de Revistas Científicas - HC/ICHC
Artigos e Materiais de Revistas Científicas - HC/ICr
Artigos e Materiais de Revistas Científicas - HC/InCor
Artigos e Materiais de Revistas Científicas - LIM/17