Long term follow-up of patients with systemic lupus erythematosus

To assess the impact of demographic and clinical factors on prognosis in patients with systemic lupus erythematosus (SLE), we studied a cohort composed of 566 patients in Huashan Hospital between 1959 and 1992 who were followed up to June 30, 1993. The survivorship was examined through life table analysis. The results showed that the survival rate from the time of SLE onset was 93% at 1 year, 73% at 5 years, and 60% at 10 years. On univariate analysis, we found that the following factors worsened the probability of survival: male, neuropsychiatric manifestations, pleurisy-pericarditis, hematological disorders, renal involvement, hypocomplementemia, abnormal electrocardiograph, and high corticosteroid dose of treatment. The time that the C3 depression occurred in the course of SLE affected the survival more significantly than did its decreased levels. The earlier the occurrence of C3 depression, the lower the patient's survival probability. On multivariate analysis, the independent risk factors were male gender, abnormal electrocardiograph, hypocomplementemia, and high corticosteroid dose of treatment. All of these indicated that clinical features of SLE might have value as predictors for its prognosis and that the occurrence of the decreased C3 in the early course of SLE might be the most important factor.