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Association of the Charlson comorbidity index with mortality in systemic lupus erythematosus

A Jönsen1, A E Clarke, L Joseph

  • 1McGill University Health Centre, Montreal, Quebec, Canada. andreas.jonsen@med.lu.se

Arthritis Care & Research
|May 28, 2011
PubMed

Insights

Comorbidity, measured by the Charlson Comorbidity Index (CCI), is linked to reduced survival in patients with systemic lupus erythematosus (SLE). This finding holds true independently of age, disease activity, and damage, highlighting the CCI's utility in SLE research.

Area of Science:

  • Rheumatology
  • Clinical Epidemiology
  • Systemic Lupus Erythematosus Research

Background:

  • Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with significant morbidity and mortality.
  • Assessing comorbidity is crucial for understanding long-term outcomes in SLE patients.
  • The Charlson Comorbidity Index (CCI) is a widely used tool for quantifying comorbidity burden.

Purpose of the Study:

  • To determine if comorbidity, as assessed by the Charlson Comorbidity Index (CCI), is associated with mortality in patients with systemic lupus erythematosus (SLE).
  • To evaluate the CCI's utility in predicting long-term survival in SLE cohorts.

Main Methods:

  • Retrospective analysis of data from 499 SLE patients in Montreal, Canada, and 170 SLE patients in Lund, Sweden.
  • Inclusion of data on demographics, disease activity, CCI, Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SDI), and antiphospholipid antibody syndrome (APS).
  • Application of Cox proportional hazards survival models to assess mortality risk.

Main Results:

  • In the Montreal cohort, CCI (HR 1.57) and age (HR 1.04) were associated with increased mortality risk.
  • In the Lund cohort, CCI (HR 1.35), age (HR 1.09), and SDI (HR 1.40) were associated with increased mortality risk.
  • No significant association found between mortality and sex, race/ethnicity, disease activity, or APS in either cohort.

Conclusions:

  • Comorbidity, as measured by the CCI, is independently associated with decreased survival in SLE patients.
  • The CCI demonstrates utility in capturing comorbidity for clinical research in SLE.
  • Age and disease damage (SDI) also contribute to mortality risk in specific SLE cohorts.
Abstract

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