Exploring the Risk Factors for Poor Survival in Lupus Pericarditis Patients: A Retrospective Cohort Study

Yen-Fu Chen1, Meng-Ru Hsieh1, Che-Tzu Chang1

  • 1Division of Rheumatology, Allergy and Immunology, Department of Internal Medicine, Chang Gung Memorial Hospital, Taoyuan City 333, Taiwan.

Journal of Clinical Medicine
|September 23, 2022
PubMed

Insights

Systemic lupus erythematosus patients with lupus pericarditis face increased mortality risk. Factors like older age, high disease activity, and kidney disease significantly elevate this risk, necessitating prompt intervention.

Area of Science:

  • Rheumatology
  • Cardiology
  • Internal Medicine

Background:

  • Systemic lupus erythematosus (SLE) patients have a heightened risk of developing pericarditis, a potentially fatal condition.
  • Lupus pericarditis is a significant clinical manifestation in SLE, impacting patient prognosis.

Purpose of the Study:

  • To identify prognostic factors associated with mortality in patients diagnosed with lupus pericarditis.
  • To analyze the mortality risk in SLE patients with and without pericarditis.

Main Methods:

  • Observational cohort study including 689 SLE patients from Chang Gung Memorial Hospital.
  • Univariate and multivariate COX regression and Kaplan–Meier survival analysis were employed.
  • Mortality risk was investigated in relation to lupus pericarditis and other clinical factors.

Main Results:

  • Lupus pericarditis was diagnosed in 16.4% of SLE patients, who were older and had higher disease activity and comorbidities.
  • Multivariate analysis identified lupus pericarditis (HR=1.963), advanced age (HR=1.053), high SLEDAI score (HR=1.079), and end-stage kidney disease (ESKD) (HR=2.533) as significant mortality predictors.
  • Kaplan–Meier analysis confirmed a higher mortality rate in patients with pericarditis (log-rank test, p < 0.001).

Conclusions:

  • Lupus pericarditis is a common and serious complication in SLE patients, independently associated with increased mortality.
  • Prognostic factors for mortality include lupus pericarditis, older age, elevated SLE disease activity, and ESKD.
  • Early diagnosis and timely treatment are crucial for improving outcomes in SLE patients with pericarditis, even in the absence of pericardial tamponade.

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