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2015 ; 94
(17
): e794
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gab.com Text
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English Wikipedia
Long-term survival and death causes of systemic lupus erythematosus in China: a
systemic review of observational studies
#MMPMID25929930
Wang Z
; Wang Y
; Zhu R
; Tian X
; Xu D
; Wang Q
; Wu C
; Zhang S
; Zhao J
; Zhao Y
; Li M
; Zeng X
Medicine (Baltimore)
2015[May]; 94
(17
): e794
PMID25929930
show ga
Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with an
increased risk of death compared to general population. Although previous studies
showed improvement in survival of SLE, the long-term prognosis has not been
elaborated in China.This study aims to integrate the observational studies
estimating current long-term survival of Chinese SLE patients and analyze the
death-cause situation of SLE in China.The study is a systemic review of English
and non-English articles using MEDLINE, EMBASE, CNKI, WANFANG, and SINOMED
databases. Additional studies were found by consultation with clinical experts,
browse of references in selected papers, and search of related textbooks. Our
major search terms were SLE, follow-up, prognosis, survival, mortality, and
China.We included cohort studies for survival analysis, and both cohort studies
and case series for death-cause analysis in China.The extraction of the articles
were done by 2 authors independently using predesigned charts, including
characteristics of study, clinical data, analyzing data, and study quality
indicators.All pooled analyses were conducted both for random-effects model and
fixed-effects model. Funnel plots and Egger regression tests were applied to
check potential publication bias. Heterogeneity was tested by sensitivity
analysis. We identified 5 studies for survival analysis comprising 4469 Chinese
patients with SLE (380 observed deaths). Thirty-six studies were suitable for
death-cause analysis with 2179 observed deaths (derived from more than 20,000
Chinese patients with SLE). The overall pooled survival rates for SLE in China
were 94% for 5-year survival rate and 89% for 10-year survival rate after disease
onset from the year 1995 to 2013, which were similar with previous publications
in Asia-Pacific area. The proportions of different causes of death showed
infection (33.2%), renal involvement (18.7%), lupus encephalopathy (13.8%), and
cardiovascular disease (11.5%) as the top 4 causes.The overall survival rates for
Chinese patients with SLE resembled previous publications in Asia-Pacific area.
But the death causes of SLE in China were of some differences indicating
relatively higher proportion of infection and lupus encephalopathy and lower
cardiovascular disease. Ethnicity and more aggressive treatment might have
contributed to the difference in death composition.