Risk factors associated with mortality in systemic lupus erythematosus. A case-control study in a tertiary care center in Mexico City
Identifieur interne : 000057 ( PascalFrancis/Corpus ); précédent : 000056; suivant : 000058Risk factors associated with mortality in systemic lupus erythematosus. A case-control study in a tertiary care center in Mexico City
Auteurs : B. Hernandez-Cruz ; N. Tapia ; A. R. Villa-Romero ; E. Reyes ; M. H. CardielSource :
- Clinical and experimental rheumatology [ 0392-856X ] ; 2001.
Descripteurs français
- Pascal (Inist)
English descriptors
- KwdEn :
Abstract
Objective To identify the mortality risk factors in a group of Mexican patients with SLE. Methods A case-control autopsy study in a tertiary care center in Mexico, City. Patients with SLE who died during 1958 to 1994 with an autopsy study were selected as cases, and alive patients matched by age (±3 years), decade of SLE onset, and disease duration (±5 years) were defined as controls. Clinical charts were reviewed looking at clinical variables. SLE disease activity was evaluated with the MexSledai index, and SLE disease severity with the Severity Index. Variables were classified as present at any moment during the follow-up and 3 months before death in cases or cut-off date in controls. Statistical analysis: matched univariate and multivariate analysis by multiple logistic regression were performed, and the results were presented as odds ratio and 95% confidence intervals (OR, 95%CI). Results 76 matched pairs of patients were studied. Age, gender; and years of formal education were similar in the cases and controls. Variables associated with mortality three months before death were: lung involvement OR=15.6, 95%CI (4.8-50.3), p<0.001; severe thrombocytopenia 9.6 (2.9-31.7), p<0.001; heart involvement 5.8 (2.6-13.0), p<0.001; and the severity index (cases 8.8 μ, 2.4 σ vs controls 3.5, 2.0, respectively) 2.2 (1.5-3.4), p<0.001. Variables associated with mortality detected at any moment before death were kidney involvement 2. 16 (1.09-4.29), p<0.02; the steroid therapeutic index 2.3 (1.2-4.5), p<0.001; number of previous admissions 2.4 (1.4-4.3), p<0.001; the MEX-SLEDAI index (cases 21.6 μ, 6.3 σ vs controls 12.6, 5.8), 1.2 (1.1-1.3), p<0.001; and the number of severe infections 14.4 (4.4-46.2), p<0.001. Protective variables were skin involvement 0.1 (0.3-0.6), p<0.001; daily dose of chloroquine (cases 3.9 μ, 24.1 σ vs controls 39.4, 60.0 mg), p<0.0001 and the time from the first SLE symptom to the patient's demise or the cut-off date 0.7(0.6-0.9), p<0.001. Multiple logistic regression showed that the model which best explained mortality consisted of a severity index 2.6 (1.7-3.8), p<0.001; heart disease 6.5 (1.5-28.2), p=0.01, and steroid therapeutic index 3.3 (1.6-6.6), p=0.001. Conclusions An active SLE with multi-organic involvement, steroids and infections were associated with mortality in Mexican patients with lupus attended in a tertiary care center. A protective effect of cutaneous disease and chloroquine use was observed.
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NO : | PASCAL 02-0044020 INIST |
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ET : | Risk factors associated with mortality in systemic lupus erythematosus. A case-control study in a tertiary care center in Mexico City |
AU : | HERNANDEZ-CRUZ (B.); TAPIA (N.); VILLA-ROMERO (A. R.); REYES (E.); CARDIEL (M. H.) |
AF : | Department of Internal Medicine, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirdn/Mexico City/Mexique (1 aut., 2 aut.); Clinical Epidemiology Unit, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirdn/Mexico City/Mexique (3 aut.); Department of Pathology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirdn/Mexico City/Mexique (4 aut.); Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirdn/Mexico City/Mexique (5 aut.) |
DT : | Publication en série; Niveau analytique |
SO : | Clinical and experimental rheumatology; ISSN 0392-856X; Italie; Da. 2001; Vol. 19; No. 4; Pp. 395-401; Bibl. 34 ref. |
LA : | Anglais |
EA : | Objective To identify the mortality risk factors in a group of Mexican patients with SLE. Methods A case-control autopsy study in a tertiary care center in Mexico, City. Patients with SLE who died during 1958 to 1994 with an autopsy study were selected as cases, and alive patients matched by age (±3 years), decade of SLE onset, and disease duration (±5 years) were defined as controls. Clinical charts were reviewed looking at clinical variables. SLE disease activity was evaluated with the MexSledai index, and SLE disease severity with the Severity Index. Variables were classified as present at any moment during the follow-up and 3 months before death in cases or cut-off date in controls. Statistical analysis: matched univariate and multivariate analysis by multiple logistic regression were performed, and the results were presented as odds ratio and 95% confidence intervals (OR, 95%CI). Results 76 matched pairs of patients were studied. Age, gender; and years of formal education were similar in the cases and controls. Variables associated with mortality three months before death were: lung involvement OR=15.6, 95%CI (4.8-50.3), p<0.001; severe thrombocytopenia 9.6 (2.9-31.7), p<0.001; heart involvement 5.8 (2.6-13.0), p<0.001; and the severity index (cases 8.8 μ, 2.4 σ vs controls 3.5, 2.0, respectively) 2.2 (1.5-3.4), p<0.001. Variables associated with mortality detected at any moment before death were kidney involvement 2. 16 (1.09-4.29), p<0.02; the steroid therapeutic index 2.3 (1.2-4.5), p<0.001; number of previous admissions 2.4 (1.4-4.3), p<0.001; the MEX-SLEDAI index (cases 21.6 μ, 6.3 σ vs controls 12.6, 5.8), 1.2 (1.1-1.3), p<0.001; and the number of severe infections 14.4 (4.4-46.2), p<0.001. Protective variables were skin involvement 0.1 (0.3-0.6), p<0.001; daily dose of chloroquine (cases 3.9 μ, 24.1 σ vs controls 39.4, 60.0 mg), p<0.0001 and the time from the first SLE symptom to the patient's demise or the cut-off date 0.7(0.6-0.9), p<0.001. Multiple logistic regression showed that the model which best explained mortality consisted of a severity index 2.6 (1.7-3.8), p<0.001; heart disease 6.5 (1.5-28.2), p=0.01, and steroid therapeutic index 3.3 (1.6-6.6), p=0.001. Conclusions An active SLE with multi-organic involvement, steroids and infections were associated with mortality in Mexican patients with lupus attended in a tertiary care center. A protective effect of cutaneous disease and chloroquine use was observed. |
CC : | 002B07 |
FD : | Lupus érythémateux; Disséminé; Facteur risque; Epidémiologie; Mortalité; Etiologie; Evolutivité; Anatomopathologie; Postmortem; Mexique; Adulte; Etude cas témoin |
FG : | Amérique Centrale; Amérique; Homme; Peau pathologie; Tissu conjonctif pathologie; Maladie système; Maladie autoimmune; Immunopathologie; Santé publique |
ED : | Lupus erythematosus; Disseminated; Risk factor; Epidemiology; Mortality; Etiology; Evolutivity; Pathology; Postmortem; Mexico; Adult; Case control study |
EG : | Central America; America; Human; Skin disease; Connective tissue disease; Systemic disease; Autoimmune disease; Immunopathology; Public health |
SD : | Lupus eritematoso; Diseminado; Factor riesgo; Epidemiología; Mortalidad; Etiología; Evolutividad; Anatomía patológica; Postmortem; México; Adulto; Estudio caso control |
LO : | INIST-20920.354000095792370060 |
ID : | 02-0044020 |
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Pascal:02-0044020Le document en format XML
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<term>Evolutivity</term>
<term>Lupus erythematosus</term>
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<term>Mortality</term>
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<keywords scheme="Pascal" xml:lang="fr"><term>Lupus érythémateux</term>
<term>Disséminé</term>
<term>Facteur risque</term>
<term>Epidémiologie</term>
<term>Mortalité</term>
<term>Etiologie</term>
<term>Evolutivité</term>
<term>Anatomopathologie</term>
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<front><div type="abstract" xml:lang="en">Objective To identify the mortality risk factors in a group of Mexican patients with SLE. Methods A case-control autopsy study in a tertiary care center in Mexico, City. Patients with SLE who died during 1958 to 1994 with an autopsy study were selected as cases, and alive patients matched by age (±3 years), decade of SLE onset, and disease duration (±5 years) were defined as controls. Clinical charts were reviewed looking at clinical variables. SLE disease activity was evaluated with the MexSledai index, and SLE disease severity with the Severity Index. Variables were classified as present at any moment during the follow-up and 3 months before death in cases or cut-off date in controls. Statistical analysis: matched univariate and multivariate analysis by multiple logistic regression were performed, and the results were presented as odds ratio and 95% confidence intervals (OR, 95%CI). Results 76 matched pairs of patients were studied. Age, gender; and years of formal education were similar in the cases and controls. Variables associated with mortality three months before death were: lung involvement OR=15.6, 95%CI (4.8-50.3), p<0.001; severe thrombocytopenia 9.6 (2.9-31.7), p<0.001; heart involvement 5.8 (2.6-13.0), p<0.001; and the severity index (cases 8.8 μ, 2.4 σ vs controls 3.5, 2.0, respectively) 2.2 (1.5-3.4), p<0.001. Variables associated with mortality detected at any moment before death were kidney involvement 2. 16 (1.09-4.29), p<0.02; the steroid therapeutic index 2.3 (1.2-4.5), p<0.001; number of previous admissions 2.4 (1.4-4.3), p<0.001; the MEX-SLEDAI index (cases 21.6 μ, 6.3 σ vs controls 12.6, 5.8), 1.2 (1.1-1.3), p<0.001; and the number of severe infections 14.4 (4.4-46.2), p<0.001. Protective variables were skin involvement 0.1 (0.3-0.6), p<0.001; daily dose of chloroquine (cases 3.9 μ, 24.1 σ vs controls 39.4, 60.0 mg), p<0.0001 and the time from the first SLE symptom to the patient's demise or the cut-off date 0.7(0.6-0.9), p<0.001. Multiple logistic regression showed that the model which best explained mortality consisted of a severity index 2.6 (1.7-3.8), p<0.001; heart disease 6.5 (1.5-28.2), p=0.01, and steroid therapeutic index 3.3 (1.6-6.6), p=0.001. Conclusions An active SLE with multi-organic involvement, steroids and infections were associated with mortality in Mexican patients with lupus attended in a tertiary care center. A protective effect of cutaneous disease and chloroquine use was observed.</div>
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<fC01 i1="01" l="ENG"><s0>Objective To identify the mortality risk factors in a group of Mexican patients with SLE. Methods A case-control autopsy study in a tertiary care center in Mexico, City. Patients with SLE who died during 1958 to 1994 with an autopsy study were selected as cases, and alive patients matched by age (±3 years), decade of SLE onset, and disease duration (±5 years) were defined as controls. Clinical charts were reviewed looking at clinical variables. SLE disease activity was evaluated with the MexSledai index, and SLE disease severity with the Severity Index. Variables were classified as present at any moment during the follow-up and 3 months before death in cases or cut-off date in controls. Statistical analysis: matched univariate and multivariate analysis by multiple logistic regression were performed, and the results were presented as odds ratio and 95% confidence intervals (OR, 95%CI). Results 76 matched pairs of patients were studied. Age, gender; and years of formal education were similar in the cases and controls. Variables associated with mortality three months before death were: lung involvement OR=15.6, 95%CI (4.8-50.3), p<0.001; severe thrombocytopenia 9.6 (2.9-31.7), p<0.001; heart involvement 5.8 (2.6-13.0), p<0.001; and the severity index (cases 8.8 μ, 2.4 σ vs controls 3.5, 2.0, respectively) 2.2 (1.5-3.4), p<0.001. Variables associated with mortality detected at any moment before death were kidney involvement 2. 16 (1.09-4.29), p<0.02; the steroid therapeutic index 2.3 (1.2-4.5), p<0.001; number of previous admissions 2.4 (1.4-4.3), p<0.001; the MEX-SLEDAI index (cases 21.6 μ, 6.3 σ vs controls 12.6, 5.8), 1.2 (1.1-1.3), p<0.001; and the number of severe infections 14.4 (4.4-46.2), p<0.001. Protective variables were skin involvement 0.1 (0.3-0.6), p<0.001; daily dose of chloroquine (cases 3.9 μ, 24.1 σ vs controls 39.4, 60.0 mg), p<0.0001 and the time from the first SLE symptom to the patient's demise or the cut-off date 0.7(0.6-0.9), p<0.001. Multiple logistic regression showed that the model which best explained mortality consisted of a severity index 2.6 (1.7-3.8), p<0.001; heart disease 6.5 (1.5-28.2), p=0.01, and steroid therapeutic index 3.3 (1.6-6.6), p=0.001. Conclusions An active SLE with multi-organic involvement, steroids and infections were associated with mortality in Mexican patients with lupus attended in a tertiary care center. A protective effect of cutaneous disease and chloroquine use was observed.</s0>
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<s5>07</s5>
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<fC03 i1="07" i2="X" l="SPA"><s0>Evolutividad</s0>
<s5>07</s5>
</fC03>
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<s5>08</s5>
</fC03>
<fC03 i1="08" i2="X" l="ENG"><s0>Pathology</s0>
<s5>08</s5>
</fC03>
<fC03 i1="08" i2="X" l="SPA"><s0>Anatomía patológica</s0>
<s5>08</s5>
</fC03>
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<s5>09</s5>
</fC03>
<fC03 i1="09" i2="X" l="ENG"><s0>Postmortem</s0>
<s5>09</s5>
</fC03>
<fC03 i1="09" i2="X" l="SPA"><s0>Postmortem</s0>
<s5>09</s5>
</fC03>
<fC03 i1="10" i2="X" l="FRE"><s0>Mexique</s0>
<s2>NG</s2>
<s5>10</s5>
</fC03>
<fC03 i1="10" i2="X" l="ENG"><s0>Mexico</s0>
<s2>NG</s2>
<s5>10</s5>
</fC03>
<fC03 i1="10" i2="X" l="SPA"><s0>México</s0>
<s2>NG</s2>
<s5>10</s5>
</fC03>
<fC03 i1="11" i2="X" l="FRE"><s0>Adulte</s0>
<s5>11</s5>
</fC03>
<fC03 i1="11" i2="X" l="ENG"><s0>Adult</s0>
<s5>11</s5>
</fC03>
<fC03 i1="11" i2="X" l="SPA"><s0>Adulto</s0>
<s5>11</s5>
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<fC03 i1="12" i2="X" l="FRE"><s0>Etude cas témoin</s0>
<s5>12</s5>
</fC03>
<fC03 i1="12" i2="X" l="ENG"><s0>Case control study</s0>
<s5>12</s5>
</fC03>
<fC03 i1="12" i2="X" l="SPA"><s0>Estudio caso control</s0>
<s5>12</s5>
</fC03>
<fC07 i1="01" i2="X" l="FRE"><s0>Amérique Centrale</s0>
<s2>NG</s2>
</fC07>
<fC07 i1="01" i2="X" l="ENG"><s0>Central America</s0>
<s2>NG</s2>
</fC07>
<fC07 i1="01" i2="X" l="SPA"><s0>America central</s0>
<s2>NG</s2>
</fC07>
<fC07 i1="02" i2="X" l="FRE"><s0>Amérique</s0>
<s2>NG</s2>
</fC07>
<fC07 i1="02" i2="X" l="ENG"><s0>America</s0>
<s2>NG</s2>
</fC07>
<fC07 i1="02" i2="X" l="SPA"><s0>America</s0>
<s2>NG</s2>
</fC07>
<fC07 i1="03" i2="X" l="FRE"><s0>Homme</s0>
</fC07>
<fC07 i1="03" i2="X" l="ENG"><s0>Human</s0>
</fC07>
<fC07 i1="03" i2="X" l="SPA"><s0>Hombre</s0>
</fC07>
<fC07 i1="04" i2="X" l="FRE"><s0>Peau pathologie</s0>
<s5>37</s5>
</fC07>
<fC07 i1="04" i2="X" l="ENG"><s0>Skin disease</s0>
<s5>37</s5>
</fC07>
<fC07 i1="04" i2="X" l="SPA"><s0>Piel patología</s0>
<s5>37</s5>
</fC07>
<fC07 i1="05" i2="X" l="FRE"><s0>Tissu conjonctif pathologie</s0>
<s5>38</s5>
</fC07>
<fC07 i1="05" i2="X" l="ENG"><s0>Connective tissue disease</s0>
<s5>38</s5>
</fC07>
<fC07 i1="05" i2="X" l="SPA"><s0>Tejido conjuntivo patología</s0>
<s5>38</s5>
</fC07>
<fC07 i1="06" i2="X" l="FRE"><s0>Maladie système</s0>
<s5>39</s5>
</fC07>
<fC07 i1="06" i2="X" l="ENG"><s0>Systemic disease</s0>
<s5>39</s5>
</fC07>
<fC07 i1="06" i2="X" l="SPA"><s0>Enfermedad sistémica</s0>
<s5>39</s5>
</fC07>
<fC07 i1="07" i2="X" l="FRE"><s0>Maladie autoimmune</s0>
<s5>40</s5>
</fC07>
<fC07 i1="07" i2="X" l="ENG"><s0>Autoimmune disease</s0>
<s5>40</s5>
</fC07>
<fC07 i1="07" i2="X" l="SPA"><s0>Enfermedad autoinmune</s0>
<s5>40</s5>
</fC07>
<fC07 i1="08" i2="X" l="FRE"><s0>Immunopathologie</s0>
<s5>41</s5>
</fC07>
<fC07 i1="08" i2="X" l="ENG"><s0>Immunopathology</s0>
<s5>41</s5>
</fC07>
<fC07 i1="08" i2="X" l="SPA"><s0>Inmunopatología</s0>
<s5>41</s5>
</fC07>
<fC07 i1="09" i2="X" l="FRE"><s0>Santé publique</s0>
<s5>45</s5>
</fC07>
<fC07 i1="09" i2="X" l="ENG"><s0>Public health</s0>
<s5>45</s5>
</fC07>
<fC07 i1="09" i2="X" l="SPA"><s0>Salud pública</s0>
<s5>45</s5>
</fC07>
<fN21><s1>021</s1>
</fN21>
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<server><NO>PASCAL 02-0044020 INIST</NO>
<ET>Risk factors associated with mortality in systemic lupus erythematosus. A case-control study in a tertiary care center in Mexico City</ET>
<AU>HERNANDEZ-CRUZ (B.); TAPIA (N.); VILLA-ROMERO (A. R.); REYES (E.); CARDIEL (M. H.)</AU>
<AF>Department of Internal Medicine, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirdn/Mexico City/Mexique (1 aut., 2 aut.); Clinical Epidemiology Unit, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirdn/Mexico City/Mexique (3 aut.); Department of Pathology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirdn/Mexico City/Mexique (4 aut.); Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirdn/Mexico City/Mexique (5 aut.)</AF>
<DT>Publication en série; Niveau analytique</DT>
<SO>Clinical and experimental rheumatology; ISSN 0392-856X; Italie; Da. 2001; Vol. 19; No. 4; Pp. 395-401; Bibl. 34 ref.</SO>
<LA>Anglais</LA>
<EA>Objective To identify the mortality risk factors in a group of Mexican patients with SLE. Methods A case-control autopsy study in a tertiary care center in Mexico, City. Patients with SLE who died during 1958 to 1994 with an autopsy study were selected as cases, and alive patients matched by age (±3 years), decade of SLE onset, and disease duration (±5 years) were defined as controls. Clinical charts were reviewed looking at clinical variables. SLE disease activity was evaluated with the MexSledai index, and SLE disease severity with the Severity Index. Variables were classified as present at any moment during the follow-up and 3 months before death in cases or cut-off date in controls. Statistical analysis: matched univariate and multivariate analysis by multiple logistic regression were performed, and the results were presented as odds ratio and 95% confidence intervals (OR, 95%CI). Results 76 matched pairs of patients were studied. Age, gender; and years of formal education were similar in the cases and controls. Variables associated with mortality three months before death were: lung involvement OR=15.6, 95%CI (4.8-50.3), p<0.001; severe thrombocytopenia 9.6 (2.9-31.7), p<0.001; heart involvement 5.8 (2.6-13.0), p<0.001; and the severity index (cases 8.8 μ, 2.4 σ vs controls 3.5, 2.0, respectively) 2.2 (1.5-3.4), p<0.001. Variables associated with mortality detected at any moment before death were kidney involvement 2. 16 (1.09-4.29), p<0.02; the steroid therapeutic index 2.3 (1.2-4.5), p<0.001; number of previous admissions 2.4 (1.4-4.3), p<0.001; the MEX-SLEDAI index (cases 21.6 μ, 6.3 σ vs controls 12.6, 5.8), 1.2 (1.1-1.3), p<0.001; and the number of severe infections 14.4 (4.4-46.2), p<0.001. Protective variables were skin involvement 0.1 (0.3-0.6), p<0.001; daily dose of chloroquine (cases 3.9 μ, 24.1 σ vs controls 39.4, 60.0 mg), p<0.0001 and the time from the first SLE symptom to the patient's demise or the cut-off date 0.7(0.6-0.9), p<0.001. Multiple logistic regression showed that the model which best explained mortality consisted of a severity index 2.6 (1.7-3.8), p<0.001; heart disease 6.5 (1.5-28.2), p=0.01, and steroid therapeutic index 3.3 (1.6-6.6), p=0.001. Conclusions An active SLE with multi-organic involvement, steroids and infections were associated with mortality in Mexican patients with lupus attended in a tertiary care center. A protective effect of cutaneous disease and chloroquine use was observed.</EA>
<CC>002B07</CC>
<FD>Lupus érythémateux; Disséminé; Facteur risque; Epidémiologie; Mortalité; Etiologie; Evolutivité; Anatomopathologie; Postmortem; Mexique; Adulte; Etude cas témoin</FD>
<FG>Amérique Centrale; Amérique; Homme; Peau pathologie; Tissu conjonctif pathologie; Maladie système; Maladie autoimmune; Immunopathologie; Santé publique</FG>
<ED>Lupus erythematosus; Disseminated; Risk factor; Epidemiology; Mortality; Etiology; Evolutivity; Pathology; Postmortem; Mexico; Adult; Case control study</ED>
<EG>Central America; America; Human; Skin disease; Connective tissue disease; Systemic disease; Autoimmune disease; Immunopathology; Public health</EG>
<SD>Lupus eritematoso; Diseminado; Factor riesgo; Epidemiología; Mortalidad; Etiología; Evolutividad; Anatomía patológica; Postmortem; México; Adulto; Estudio caso control</SD>
<LO>INIST-20920.354000095792370060</LO>
<ID>02-0044020</ID>
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