Prognostic factors of systemic lupus erythematosus patients with pulmonary embolism: An 11-year cohort study

Systemic lupus erythematosus (SLE) patients have a higher risk of pulmonary embolism (PE) which is life-threatening, but there has been no research focusing on the prognosis of SLE patients with PE. This study was conducted to explore the prognostic factors of mortality in SLE patients with PE.

In this observational cohort study, SLE inpatients with PE treated at Peking Union Medical College Hospital between January 2010 and December 2020 were included and age, gender, smoking history, the onset of SLE and PE, organ involvement, SLE disease activity index-2000 (SLEDAI-2K), severity of PE, and treatment regimen were collected. Kaplan-Meier survival curve and univariate and multivariate COX regression analysis were used to explore the prognostic factors of SLE patients with PE.

A total of 86 SLE patients with PE were enrolled, with the age of 37.72±15.79 years old and the average lupus duration of 46.5 months. 17 patients (19.77%) died. 1- and 3-year survival rates were 83.40% and 79.40%. Thrombocytopenia (log-rank p = 0.004) and lymphocytopenia (log-rank p = 0.030) were predictors of mortality, and effective anticoagulation (log-rank p = 0.032), hydroxychloroquine (HCQ) (log-rank p = 0.021) were protective factors of mortality in SLE patients with PE. Effective anticoagulation was an independent protective factor of mortality in SLE patients with PE (HR = 0.14, p = 0.006).

Patients with thrombocytopenia and lymphocytopenia are more likely to develop a poor prognosis. Effective anticoagulation and HCQ could improve the prognosis.