ABSTRACT
Objective:To analyze the 15-year survival rate, causes of death and prognostic factors of late-onset systemic lupus erythematosus(SLE).Methods:A total of 92 late-onset SLE patients aged >50 years hospitalized in the Rheumatology and Immunology Department of the People's Hospital of Xinjiang Autonomous Region from January 2006 to December 2016 were retrospectively collected.Clinical and serological data of the patients were analyzed and the diagnosis met the SLE classification criteria as revised by the American Society of Rheumatology in 1997.Survival rate, the cause of death, and the associated prognostic factors were analyzed.Outpatient or telephone follow-up was performed.Results:Of the 92 study patients, 8 were lost to follow-up(8 / 92, 8.7%)and 84 were able to follow up(84 / 92, 91.3%). Of the 84 able to follow up, 64 cases(64 / 84, 76.2%)survived, and 20 cases(20 / 84, 23.8%)died.Median survival time was 108 months.The 5-, 10-, and15-year survival rates were 86.0%, 77.9%and 59.6 %, respectively.Infection(55.0%)and multiple organ failure(15.0%)were the major cause of death in patients with late-onset SLE.Univariate analysis of the outcomes of patients with late-onset SLE showed that the age of onset( HR=1.113, P=0.001), hematology involvement( HR=3.610, P=0.023), and complicaed cardiovascular disease( HR=3.128, P=0.011)had a significant impact on the prognosis. Conclusions:The late-onset SLE has low survival rate and bad prognosis.Infection prevention and control of organ damage and focus on merging cardiovascular disease are critical to improve survival of late-onset SLE patients.
ABSTRACT
Objective To assess the clinical characteristics of systemic lupus erythematosus (SLE) in the elderly in Xinjiang.Methods As a retrospective study,clinical date and laboratory test results were collected from 87 elderly SLE patients and 222 non-elderly SLE patients (age ＜ 50 years) hospitalized in the People's Hospital of the Xinjiang Uygur Autonomous Region from January 2006 to July 2016.Results The female to maleratio was 5.7 ∶ 1.0 in the older-onset SLE group and the female to male ratio was 11.3 ∶ 1.0 in the younger-onset SLE group.Of the 13 patients with predisposing factors in the older-onset SLE group(14.9 ％),11 had infection (12.6 ％),whereas the 27 patients with predisposing factors in the younger-onset SLE group (12.2 ％)had pregnancy,abortion or insolation,in addition to infection.Arthritis (63.2 ％),weakness (40.2 ％),malar rashes (36.8 ％),anorexia(26.4 ％),and shortness of breath(26.4 ％) were common clinical manifestations in the olderonset SLE group.The incidence of anorexia in the older-onset SLE group was higher than that in the younger-onset SLE group(P＜0.01),while the incidence of trichomadesis was lower in the older-onset SLE group than that in the younger-onset SLE group(P＜0.01);Aminotransferase elevation,creatinine elevation and thrombocytopenia were more common in the older-onset SLE group than in the younger SLE group (P＜0.05).Lower rates of positive anti-Smanti body and anti-Acl antibody were found in the older onset SLE group,compared with the younger-onset SLE group (P＜0.05);Han older-onset SLE patients showed higher rates of oral ulcers than older-onset SLE patients of Uygur,Kazak or other ethnic minorities (P＜0.05).There were no significant differences between Han and Uygur/Kazak patients in laboratory test results.Conclusions The proportion of male SLE patients in the elderly is higher than that in non-elderly SLE patients in Xinjiang.Also,elderly SLE patients are prone to oral ulcers but often do not show typical early clinical symptoms and have low levels of specific antibodies.Therefore,clinicians should pay particular attention to older onset SLE patients in order to reduce the rates of misdiagnosis and missed diagnosis.