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- Title
Onset age affects mortality and renal outcome of female systemic lupus erythematosus patients: a nationwide population-based study in Taiwan.
- Authors
Chen, Yi-Ming; Lin, Ching-Heng; Chen, Hsin-Hua; Chang, Shih-Ni; Hsieh, Tsu-Yi; Hung, Wei-Ting; Hsieh, Chia-Wei; Lai, Kuo-Lung; Lan, Joung-Liang; Chen, Der-Yuan; Lan, Tsuo-Hung
- Abstract
Objective. The objective of this study was to investigate the impact of disease onset age on mortality and renal survival in female SLE patients.Methods. This nationwide, population-based, retrospective cohort study used data from the National Health Insurance Research Database of Taiwan. Female patients newly diagnosed with SLE from 2001 to 2004 were identified as the study cohort. A non-SLE group was matched for age, sex and initial diagnosis date (index date) as the comparison cohort. Co-morbidities, mortality rates and end-stage renal disease (ESRD) incidences were compared among SLE patients of different onset age. Hazard ratios with a 95% CI were determined by the Cox proportional hazard model to quantify the mortality rates and ESRD incidences. Juvenile-onset, adult-onset and late-onset SLE patients were categorized according to disease onset age: <18, 18–50 and >50 years old.Results. In total, 513 juvenile-onset, 3076 adult-onset and 764 late-onset SLE patients were identified. Compared with non-SLE controls, the hazard ratios of mortality were 6.49 (95% CI 3.73, 11.32, P < 0.001) for juvenile-onset, 1.75 (95% CI 1.47, 2.08, P < 0.001) for adult-onset and 3.44 (95% CI 2.76, 4.28, P < 0.001) for late-onset SLE patients. The hazard ratios of incident ESRD were 20.28 (95% CI 12.79, 32.15, P < 0.001) for adult-onset lupus patients and 1.99 (95% CI 1.36, 2.93, P < 0.001) for late-onset patients.Conclusion. Female patients with late-onset SLE carried a higher risk of mortality than those with adult-onset disease in the presence of co-morbidities. Juvenile-onset SLE patients were at greatest risk of mortality, which is probably due to disease severity.
- Subjects
TAIWAN; SYSTEMIC lupus erythematosus; LUPUS nephritis; ACADEMIC medical centers; AGE distribution; CHRONIC kidney failure; CONFIDENCE intervals; STATISTICAL correlation; DATABASES; MEDICAL information storage &; retrieval systems; MORTALITY; COMORBIDITY; PROPORTIONAL hazards models; RETROSPECTIVE studies; SEVERITY of illness index; DATA analysis software; DESCRIPTIVE statistics; PROGNOSIS
- Publication
Rheumatology, 2014, Vol 53, Issue 1, p180
- ISSN
1462-0324
- Publication type
Article
- DOI
10.1093/rheumatology/ket330