Objective. To investigate the associations of age, sex, race, and socioeconomic status with long-term survival in patients with systemic lupus erythematosus (SLE).Methods. We examined survival in an inception cohort of 408 patients with SLE. The cohort included 177 black females, 162 white females, 49 white males, and 20 black males. The median duration of followup was 11 years (range 0.1-22 years).Results. One hundred forty-four patients died during the study. The 5-, lo-, and 15-year survival estimates for the entire cohort were 82%, 71%, and 63 % , respectively. In univariate analyses, mortality rates increased with age and were higher among males, blacks, those without private medical insurance, and those living in census tracts with lower household incomes. In multivariate analyses, age, sex, and both socioeconomic indicators were associated with total mortality (mortality from any cause), while race was not. Lower socioeconomic status and increased age were also associated with higher rates of death from SLE.Conclusion. Socioeconomic status, but not race, is associated with mortality in SLE. SLE-related mortality also tends to increase with age, which suggests that SLE may not be less severe when it occurs later in life.

Objective. To describe the causes of death in a cohort of patients with systemic lupus erythematosus (SLE), and to determine if the major causes of death differ according to patient age, sex, race, socioeconomic status, and the duration of SLE.Methods. We examined survival in a cohort of 408 patients with SLE. During a median of 11 years of followup, 144 patients died. The cause of death was determined for 134 patients (93%).Results. SLE was the most common cause of death, occurring in 49 patients (34%), followed by infection (n = 32; 22%), cardiovascular disease (n = 23; 16%), cerebrovascular disease (n = 8; 6%), and cancer (n = 8; 6%). Deaths due to SLE and due to infections were more common among younger patients, and deaths due to cancer were more common among older patients. Although the risk of death due to SLE was greatest during the first 3 years after diagnosis, deaths due to SLE occurred throughout the course of disease.Conclusion. In this study of patients with SLE who were followed up for an extended period of time beginning soon after diagnosis, SLE was the most common cause of death, and deaths due to SLE occurred throughout the course of illness.Survival in systemic lupus erythematosus (SLE) has improved over the last several decades so

The presence of nephritis and seizures each increased the risk of death in patients with SLE approximately 2-fold. Thrombocytopenia also increased the risk of SLE-related mortality, while leukopenia was protective.

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