fetching data ... 
Background: Systemic Lupus Erythematosus (SLE) is a chronic autoimmune disease characterized by widespread inflammation and tissue damage. Despite of improvements in survival rate for SLE, morality rate remains high compared with the general population. It is important to identify risk factors for mortality and provide appropriate management to improve survival rate.
Objectives: The purpose of this study is to investigate risk factor for all-cause mortality in SLE patients with national cohort database.
Methods: This study analyzed data from the National Health Insurance Service-National Sample Cohort. It randomly selected about 1 million participants, comprising 2.2% of the total eligible population. SLE patients was defined as both ICD 10 code (M32.0) and rare intractable disease code (V136) from 2004 to 2015. Controls were selected (1:5 ratio) by matching for age, sex, and index year. Baseline characteristics and all-cause mortality rate were compared in both groups, and Cox regression analysis was conducted to identify the risk factors for all-cause mortality.
Results: Total 633 SLE patients and 3,165 controls were enrolled. Baseline characteristics were shown in Table 1. Body mass index was lower, and moderate drinker were smaller, however the prevalence of hypertension and hyperlipidemia was higher in SLE group compared to controls. All-cause mortality rate was significantly higher in SLE group. Main causes of death were SLE, lung cancer, non-follicular lymphoma, chronic kidney disease, and interstitial lung disease etc. Univariate and multivariate Cox regression analysis was performed with using significant variables between both groups. SLE and glomerular filtration rate (GFR) were significant risk factors for all-cause mortality in multivariate analysis (Table 2).
Conclusion: SLE itself and low GFR were significant risk factors for all-cause mortality in SLE patients.
Clinical characteristics of study population
| Variables | SLE
| Control
| P-value |
|---|---|---|---|
| Sex | 564 (89.1) | 2820 (89.1) | 1.0000 |
| Age | 38.13 ± 14.19 | 38.13 ± 14.18 | 1.0000 |
| BMI (kg/m 2 ) | 22.66 ± 3.41 | 23.14 ± 3.45 | 0.0108 * |
| Smoking | |||
| None or past smoker | 597 (94.31) | 2,981 (94.19) | 0.9238 |
| Current smoker | 36 (5.69) | 184 (5.81) | |
| Alcohol consumption | |||
| None or occasional drinker | 617 (97.47) | 3,020 (95.42) | 0.0265 * |
| Moderate drinker (≥3/week) | 16 (2.53) | 145 (4.58) | |
| Comorbidities (%) | |||
| Hypertension | 37 (5.85) | 76 (2.40) | <0.0001 *** |
| Diabetes mellitus | 4 (0.63) | 23 (0.73) | 1.0000 |
| Hyperlipidemia | 8 (1.26) | 13 (0.42) | 0.0153 * |
| Renal failure | 2 (0.32) | 1 (0.03) | 0.0740 |
| Ischemic heart disease | 1 (0.16) | 4 (0.13) | 1.0000 |
| Laboratory findings | |||
| Hemoglobin (mg/dL) | 12.76 ± 1.50 | 13.00 ± 1.46 | 0.0020 ** |
| GFR (ml/min/1.73m 2 ) | 87.55 ± 28.88 | 92.18 ± 45.69 | 0.0368 * |
| Fasting blood sugar (mg/dL) | 89.00 ± 17.64 | 94.27 ± 18.66 | <0.0001 *** |
| Total cholesterol (mg/dL) | 177.4 ± 37.98 | 193.00 ± 35.97 | <0.0001 *** |
| HDL (mg/dL) | 54.43 ± 19.56 | 58.74 ± 20.00 | <0.0001 *** |
| LDL (mg/dL) | 100.80 ± 32.74 | 121.6 ± 23.70 | <0.0001 *** |
| Triglyceride (mg/dL) | 114.1 ± 62.84 | 109.50 ± 77.38 | 0.1956 |
| All-cause mortality | 69 (10.90) | 117 (3.70) | <0.0001 *** |
Results are expressed as means ± standard deviations or numbers and frequencies (%).
SLE systemic lupus erythematosus, BMI body mass index, GFR glomerular filtration rate, HDL high density lipoprotein, LDL low density lipoprotein
P<0.05, ** P<0.01, *** P<0.0001
Cox regression analysis for all-cause mortality in SLE patients
| Univariate | Multivariate | |||
|---|---|---|---|---|
| Hazard ratio (95% CI) | P-value | Hazard ratio (95% CI) | P-value | |
| SLE | 4.702
| <0.0001 *** | 6.647
| <0.0001 *** |
| BMI (kg/m 2 ) | 0.934
| 0.0596 | 0.953
| 0.3458 |
| Alcohol | ||||
| None or occasional drinker | ref | Ref | ||
| Moderate drinker | 1.220
| 0.6398 | 1.652
| 0.4139 |
| Comorbidities | ||||
| Hypertension | 4.766
| <0.0001 *** | 1.862
| 0.3242 |
| Hyperlipidemia | 4.595
| 0.0025 ** | 1.9372
| 0.9881 |
| Laboratory findings | ||||
| Hemoglobin (mg/dL) | 0.897
| 0.146 | 0.978
| 0.8212 |
| GFR (ml/min/1.73m 2 ) | 0.963
| <0.0001 *** | 0.975
| 0.0002 ** |
| Fasting glucose (mg/dL) | 0.999
| 0.8374 | 1.003
| 0.6984 |
| Total cholesterol (mg/dL) | 1.000
| 0.8616 | 1.002
| 0.3624 |
| HDL (mg/dL) | 0.994
| 0.4883 | 1.005
| 0.4010 |
| LDL (mg/dL) | 1.000
| 0.8197 | 1.000
| 0.8693 |
SLE systemic lupus erythematosus, BMI body mass index, GFR glomerular filtration rate, HDL high density lipoprotein, LDL low density lipoprotein
P<0.05, ** P<0.01, *** P<0.0001
REFERENCES: NIL.
Acknowledgements: NIL.
Disclosure of Interests: None declared.
© The Authors 2025. This abstract is an open access article published in Annals of Rheumatic Diseases under the CC BY-NC-ND license (