Patient-Reported Outcomes Predict Mortality in Lupus.

Area of Science:

• Rheumatology
• Clinical Epidemiology

Background:

• Physician assessments of disease activity and damage are established predictors of mortality in systemic lupus erythematosus (SLE).
• Patient-reported outcomes (PROs) are increasingly recognized as mortality predictors in chronic diseases, but their role in SLE requires further investigation.

Purpose of the Study:

• To determine if patient-reported outcomes (PROs) predict mortality in patients with systemic lupus erythematosus (SLE).

Main Methods:

• Data from 728 SLE patients in the University of California at San Francisco Lupus Outcomes Study were analyzed.
• PROs including SF-36 subscales, self-rated health, and depression (CES-D) at baseline were used to predict mortality.
• Cox regression analyses, both univariate and multivariate, were performed, controlling for demographic and disease-specific factors.

Main Results:

• Lower scores on the SF-36 physical function subscale at baseline independently predicted mortality in SLE patients.
• This association remained significant after adjusting for age, sex, race, poverty, disease duration, disease activity, and damage.
• Neither SF-36 mental health subscale nor CES-D scores were associated with mortality in multivariate analyses.

Conclusions:

• Patient-reported physical function is an independent predictor of mortality in SLE.
• PROs offer a valuable, easily assessable tool for identifying SLE patients at higher risk of mortality.
• These findings suggest PROs can aid in triaging and guiding early interventions for at-risk SLE populations.