Hospitalisation for systemic lupus erythematosus associates with an increased risk of mortality in Australian patients from 1980 to 2014: A longitudinal, population-level, data linkage, cohort study

12Citations
Citations of this article
16Readers
Mendeley users who have this article in their library.

Abstract

Objective Mortality rates for patients with SLE have not been reported in Australia. This study determined the association between a hospitalisation for SLE with mortality. Methods Population-level cohort study of patients with SLE (n=2112; 25 710 person-years) and general population comparators (controls) (n=21, 120; 280 637 person-years) identified from hospital records contained within the WA Rheumatic Disease Epidemiological Registry from 1980 to 2013. SLE was identified by ICD-9-CM: 695.4, 710.0, ICD-10-AM: L93.0, M32.0. Controls were nearest matched (10:1) for age, sex, Aboriginality and temporality. Using longitudinal linked health data, we assessed the association between a hospitalisation for SLE mortality and mortality with univariate and multivariate Cox proportional hazards and competing risks regression models. Results At timezero, patients with SLE were similar in age (43.96 years), with higher representation of females (85.1% vs 83.4%, p=0.038), Aboriginal Australians (7.8% vs 6.0%) and smokers (20.5% vs 13.2%). Before study entry, patients with SLE (mean lookback 9 years) had higher comorbidity accrual (Charlson Comorbidity Index ≥1 item (42.0% vs 20.5%)), especially cardiovascular disease (CVD) (44.7% vs 21.0%) and nephritis (16.4% vs 0.5%), all p<0.001. During follow-up (mean 12.5 years), 548 (26.0%) patients with SLE and 2450 (11.6%) comparators died. A hospitalisation for SLE increased the unadjusted (HR 2.42, 95% CI 2.20 to 2.65) and multivariate-adjusted risk of mortality (aHR 2.03, 95% CI 1.84 to 2.23), which reduced from 1980 to 1999 (aHR 1.42) to 2000-2014 (aHR 1.27). Females (aHR 2.11), Aboriginal Australians (aHR 3.32), socioeconomically disadvantaged (aHR 2.49), and those <40 years old (aHR 7.46) were most vulnerable. At death, patients with SLE had a higher burden of infection (aHR 4.38), CVD (aHR 2.09) and renal disease (aHR 3.43), all p<0.001. Conclusions A hospitalisation for SLE associated with an increased risk of mortality over the 1980-2014 period compared with the general population. The risk was especially high in younger (<40 years old), socioeconomically disadvantaged and Aboriginal Australians.

References Powered by Scopus

Updating and validating the charlson comorbidity index and score for risk adjustment in hospital discharge abstracts using data from 6 countries

4293Citations
N/AReaders
Get full text

Population-based linkage of health records in Western Australia: Development of a health services research linked database

938Citations
N/AReaders
Get full text

The bimodal mortality pattern of systemic lupus erythematosus

912Citations
N/AReaders
Get full text

Cited by Powered by Scopus

Mechanistic insight into premature atherosclerosis and cardiovascular complications in systemic lupus erythematosus

22Citations
N/AReaders
Get full text

Gastrointestinal Manifestations in Patients with Systemic Lupus Erythematosus

10Citations
N/AReaders
Get full text

Multiplicative Impact of Adverse Social Determinants of Health on Outcomes in Lupus Nephritis: A Meta-analysis and Systematic Review

2Citations
N/AReaders
Get full text

Register to see more suggestions

Mendeley helps you to discover research relevant for your work.

Already have an account?

Cite

CITATION STYLE

APA

Raymond, W. D., Lester, S., Preen, D. B., Keen, H. I., Inderjeeth, C. A., Furfaro, M., & Nossent, J. C. (2021). Hospitalisation for systemic lupus erythematosus associates with an increased risk of mortality in Australian patients from 1980 to 2014: A longitudinal, population-level, data linkage, cohort study. Lupus Science and Medicine, 8(1). https://doi.org/10.1136/lupus-2021-000539

Readers' Seniority

Tooltip

PhD / Post grad / Masters / Doc 4

67%

Professor / Associate Prof. 1

17%

Researcher 1

17%

Readers' Discipline

Tooltip

Medicine and Dentistry 3

50%

Business, Management and Accounting 1

17%

Pharmacology, Toxicology and Pharmaceut... 1

17%

Mathematics 1

17%

Article Metrics

Tooltip
Mentions
News Mentions: 1
Social Media
Shares, Likes & Comments: 24

Save time finding and organizing research with Mendeley

Sign up for free