Association of the Charlson Comorbidity Index With Mortality in Systemic Lupus Erythematosus
Association of the Charlson Comorbidity Index With Mortality in Systemic Lupus Erythematosus
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DOI：
10.1002/acr.20506
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发表时间：
2011-09-01
影响因子：
4.7
通讯作者：
Pineau, C. A.
中科院分区：
文献类型：
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作者：
Joensen, A.;Clarke, A. E.;Pineau, C. A.
Objective.通过对系统性红斑狼疮（SLE）患者的长期随访，研究Charlson合并症指数（CCI）评估的合并症是否与死亡率相关。数据收集自加拿大魁北克省蒙特利尔市麦吉尔大学健康中心狼疮诊所的499例SLE患者和瑞典隆德大学医院流变学系的170例SLE患者。这包括合并症、人口统计学、疾病活动、系统性狼疮国际合作诊所/美国流变学学院损伤指数（SDI）和抗磷脂抗体综合征（APS）的数据。将变量输入考克斯比例风险生存模型。蒙特利尔队列中的死亡风险与CCI（CCI每增加1个单位的风险比[HR] 1.57，95%置信区间[95% CI] 1.18-2.09）和年龄（年龄每增加1个单位的风险比[HR] 1.04，95% CI 1.00-1.09）相关。在隆德队列中，CCI和诊断时的年龄也与死亡率相关（CCI：HR 1.35，95% CI 1.13-1.60;年龄：HR 1.09，95% CI 1.05-1.12）。此外，SDI与隆德队列中的死亡率相关（HR 1.40，95% CI 1.19-1.64），而蒙特利尔队列中估计值的较宽CI妨碍得出明确结论（HR 1.20，95% CI 0.97-1.48）。我们没有发现死亡率与性别、种族/民族、疾病活动性或APS之间存在强相关性。在这项研究中，由CCI测量的合并症与独立于年龄、狼疮疾病活动和损害的生存率降低相关。这表明CCI可能有助于捕获SLE临床研究的合并症。
Objective. To investigate whether comorbidity as assessed by the Charlson Comorbidity Index (CCI) is associated with mortality in a long-term followup of systemic lupus erythematosus (SLE) patients.Methods. Data were collected from 499 SLE patients attending the Lupus Clinic at the McGill University Health Center, Montreal, Quebec, Canada, and 170 SLE patients from the Department of Rheumatology at Lund University Hospital, Lund, Sweden. This included data on comorbidity, demographics, disease activity, the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SDI), and antiphospholipid antibody syndrome (APS). Variables were entered into a Cox proportional hazards survival model.Results. Mortality risk in the Montreal cohort was associated with the CCI (hazard ratio [HR] 1.57 per unit increase in the CCI, 95% confidence interval [95% CI] 1.18-2.09) and age (HR 1.04 per year increase in age, 95% CI 1.00-1.09). The CCI and age at diagnosis were also associated with mortality in the Lund cohort (CCI: HR 1.35, 95% CI 1.13-1.60; age: HR 1.09, 95% CI 1.05-1.12). Furthermore, the SDI was associated with mortality in the Lund cohort (HR 1.40, 95% CI 1.19-1.64), while a wide CI for the estimate in the Montreal cohort prevented a definitive conclusion (HR 1.20, 95% CI 0.97-1.48). We did not find a strong association between mortality and sex, race/ethnicity, disease activity, or APS in either cohort.Conclusion. In this study, comorbidity as measured by the CCI was associated with decreased survival independent of age, lupus disease activity, and damage. This suggests that the CCI may be useful in capturing comorbidity for clinical research in SLE.