The Survival Rate of Hospitalized Lupus Patients With Overlap Disease

TL;DR

This study found that hospitalized lupus patients with other autoimmune diseases had a 75% survival rate, with infections being the main cause of death.

Contribution

The study provides new insights into survival rates of lupus patients with overlapping autoimmune diseases and identifies risk factors.

Findings

The general survival rate of SLE patients with at least one autoimmune disease was around 75%.

Overlap with APS, scleroderma, and RA, and male gender worsened survival rates.

Infection was the main cause of mortality in these patients.

Abstract

Objective

Systemic lupus erythematosus (SLE) is a multisystem autoimmune disease associated with a rate of mortality during hospitalization. On the other hand, SLE can be associated with other autoimmune diseases with different morbidity and mortality, so a combination of SLE and other autoimmune diseases, as overlap diseases, may increase the risk of morbidity and mortality. The aim of this study was to determine the survival rate of hospitalized SLE patients who also had other autoimmune diseases.

Method

We used a retrospective data collection from the inpatient files collected over the past 10 years in the Shariati Hospital, Rheumatology Department, Tehran University of Medical Sciences.

Results

We identified 219 patients with SLE who overlapped with other autoimmune diseases. Nearly 90% (n=197) were female patients. The mean age of patients was 37.9 years. The most common overlap autoimmune disease alongside SLE was anti-phospholipid syndrome (APS; n=99; 45.4%), followed by rheumatoid arthritis (RA) and scleroderma (n=29; 13.3% each). We had eight (3.7%) deaths in the hospitalized patients, of which six (75.0%) were female patients. The SLE patients who had overlap with APS, scleroderma, and RA died during hospitalization. The general survival rate of SLE patients with at least one autoimmune disease was around 75% (n=164), and the female patients had a better survival rate than the male patients (n=152; 77.0% and n=12; 75.0%, respectively). Infection was the main cause of mortality.

Conclusion

The general survival rate of SLE patients with at least one autoimmune disease was around 75%. Presence of overlap with APS, scleroderma and RA, and male gender worsened the survival rate.

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