SAT0221 FACTORS AFFECTING MORTALITY OF SYSTEMIC LUPUS ERYTHEMATOSUS PATIENTS IN SPAIN IN THE 21ST CENTURY: DATA FROM THE RELESSER REGISTRY

Abstract

Background/Purpose: The mortality in Systemic Lupus Erythematosus (SLE) varies largely across different countries most probably due to social, healthcare and ethnic differences. To analyze the causes and identify predictive factors of mortality of SLE in Spain in the present century. Method(s): We performed a cross-sectional and retrospective study analyzing data from the RELESSER cohort (Spanish Registry of Systemic Lupus Erythematosus of the Spanish Society of Rheumatology). We included all patients diagnosed with SLE since the year 2000 and recorded sociodemographic, clinical and serological variables, comorbidities and treatments, as well as indicators of disease activity, damage and severity. The characteristics of the deceased patients were compared with those of the survivors, and variables with clinical significance or statistical significance were grouped into multivariate models to determine which ones were independently associated with the outcome of the disease. Result(s): A total of 2004 patients were included, 88.6% female, the mean age at diagnosis was 38.3 (+/- 15.3) years, with a mean delay in diagnosis of 28.9 (+/- 52.6) months. Up to 2.84% of the individuals had died. The leading cause of death was SLE activity (n=16), followed by infections (n=14), vascular events (n=12) and cancer (n=6). The mean age of death was 54.68 (+/- 20.13) years, and neither age, sex nor delay in diagnosis was independently associated with mortality. The presence of nephritis, depression, severe infections, organ damage (SLICC/ACR DI) or disease activity (SLEDAI), as well as the use of cyclophosphamide, rituximab or high doses of corticosteroids, were predictors of mortality in our cohort. Antimalarial treatment and skin manifestations were linked to improved survival. Conclusion(s): In the RELESSER cohort, clinical factors, co-morbidities, as well as therapeutic attitudes were associated with a significant increase in mortality in SLE. Interestingly, depression was independently associated to mortality. The activity of the disease and infections continue to be the main causes of death at the beginning of the 21st century amongst our patients.