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

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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 RM
dc.contributor.authorPereira, Rosa MR
dc.contributor.authorSaad-Magalhaes, Claudia [UNESP]
dc.contributor.authorRusso, Gleice CS
dc.contributor.authorLen, Claudio A
dc.contributor.authorPrado, Rogerio do
dc.contributor.authorCampos, Lucia MA
dc.contributor.authorAikawa, Nadia E
dc.contributor.authorAppenzeller, Simone
dc.contributor.authorFerriani, Virginia PL
dc.contributor.authorSilva, Marco F
dc.contributor.authorFelix, Marta
dc.contributor.authorFonseca, Adriana R
dc.contributor.authorAssad, Ana PL
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 MH
dc.contributor.authorBonfa, Eloisa
dc.contributor.authorTerreri, Maria T
dc.contributor.institutionUniversidade Federal de São Paulo (UNIFESP)
dc.contributor.institutionUniversidade de São Paulo (USP)
dc.contributor.institutionHospital da Crianca de Brasilia Jose Alencar
dc.contributor.institutionUniversidade Estadual Paulista (UNESP)
dc.contributor.institutionUniversidade Estadual de Campinas (UNICAMP)
dc.contributor.institutionHospital Geral de Fortaleza
dc.contributor.institutionUniversidade Federal do Rio de Janeiro (UFRJ)
dc.contributor.institutionErnesto University Hospital
dc.contributor.institutionIrmandade da Santa Casa de Misericordia de Sao Paulo
dc.contributor.institutionJoao Pessoa
dc.contributor.institutionFederal University of Para
dc.contributor.institutionHospital Darcy Vargas
dc.contributor.institutionUniversidade Federal da Bahia (UFBA)
dc.contributor.institutionHospital Evangelico de Curitiba
dc.contributor.institutionHospital Criança Conceição
dc.contributor.institutionUniversidade Federal de Pernambuco (UFPE)
dc.contributor.institutionFederal University of Mato Grosso do Sul
dc.contributor.institutionUniversity of Brasilia
dc.contributor.institutionUniversidade Federal de Minas Gerais (UFMG)
dc.date.accessioned2023-07-29T13:52:09Z
dc.date.available2023-07-29T13:52:09Z
dc.date.issued2023-05-01
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.en
dc.description.affiliationPediatric Rheumatology Unit Universidade Federal de Sao Paulo, SP
dc.description.affiliationPediatric Rheumatology Unit Faculdade de Medicina Universidade de Sao Paulo
dc.description.affiliationPediatric Rheumatology Unit Hospital da Crianca de Brasilia Jose Alencar, DF
dc.description.affiliationDivision of Rheumatology Hospital das Clinicas HCFMUSP Universidade de Sao Paulo, SP
dc.description.affiliationPediatric Rheumatology Division Sao Paulo State University (UNESP) Faculdade de Medicina de Botucatu, SP
dc.description.affiliationDepartment of Orthopedics Rheumatology and Traumatology – School of Medical Science University of Campinas (UNICAMP), SP
dc.description.affiliationPediatric Rheumatology Unit Preto Medical School University of Sao Paulo, SP
dc.description.affiliationPediatric Rheumatology Unit Hospital Geral de Fortaleza, CE
dc.description.affiliationPediatric Rheumatology Unit Universidade Federal do Rio de Janeiro (UFRJ), RJ
dc.description.affiliationPediatric Rheumatology Unit Ernesto University Hospital, RJ
dc.description.affiliationPediatric Rheumatology Unit Irmandade da Santa Casa de Misericordia de Sao Paulo, SP
dc.description.affiliationRheumatology Division - Universidade Federal do Rio de Janeiro Rio de Janeiro, RJ
dc.description.affiliationPediatric Rheumatology Unit Lauro Vanderley University Hospital Joao Pessoa, PB
dc.description.affiliationPediatric Rheumatology Unit Federal University of Para, PA
dc.description.affiliationPediatric Rheumatology Unit Hospital Darcy Vargas, SP
dc.description.affiliationPediatric Rheumatology Unit Federal University of Bahia, Salvador, BA
dc.description.affiliationPediatric Rheumatology Unit Hospital Evangelico de Curitiba, PR
dc.description.affiliationPediatric Rheumatology Unit Hospital Criança Conceicao, Porto Alegre, RS
dc.description.affiliationPediatric Rheumatology Unit Federal University of Pernambuco, PE
dc.description.affiliationPediatric Rheumatology Unit Federal University of Mato Grosso do Sul, Campo Grande, MS
dc.description.affiliationPediatric Rheumatology Unit University of Brasilia, DF
dc.description.affiliationPediatric Rheumatology Unit Federal University of Minas Gerais, Belo Horizonte, MG
dc.description.affiliationRheumatology Unit University of Brasilia, DF
dc.description.affiliationUnespPediatric Rheumatology Division Sao Paulo State University (UNESP) Faculdade de Medicina de Botucatu, SP
dc.format.extent781-790
dc.identifierhttp://dx.doi.org/10.1177/09612033231170515
dc.identifier.citationLupus, v. 32, n. 6, p. 781-790, 2023.
dc.identifier.doi10.1177/09612033231170515
dc.identifier.issn1477-0962
dc.identifier.issn0961-2033
dc.identifier.scopus2-s2.0-85153118902
dc.identifier.urihttp://hdl.handle.net/11449/248730
dc.language.isoeng
dc.relation.ispartofLupus
dc.sourceScopus
dc.subjectChildhood
dc.subjectchildhood-onset systemic lupus erythematosus
dc.subjectlupus nephritis
dc.subjectmortality
dc.subjectsepsis
dc.titleRisk factors for mortality in 1528 Brazilian childhood-onset systemic lupus erythematosus patientsen
dc.typeArtigo
unesp.author.orcid0000-0003-2713-3324[1]
unesp.author.orcid0000-0001-9250-6508[2]
unesp.author.orcid0000-0002-3723-5028[8]
unesp.author.orcid0000-0001-8636-1744[11]
unesp.author.orcid0000-0001-8370-5062[12]
unesp.author.orcid0000-0001-9653-0468[13]
unesp.author.orcid0000-0002-7585-4348[14]
unesp.author.orcid0000-0002-0520-4681[35]

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