Causes of death were examined for 1,103 systemic lupus erythematosus patients who were followed from 1965 to 1978 at 9 centers that participated in the Lupus Survival Study Group. A total of 222 patients (20%) died. Lupus-related organ system involvement (mainly active nephritis) and infection were the most frequent primary causes of death. Causes of death were similar throughout the followup period. Hemodialysis had little impact on the length of survival for patients with nephritis. Active central nervous system disease and myocardial infarction were infrequent causes of death. There were no deaths from malignancy.Despite a linear improvement in survival rates since the turn of the century (l), mortality in systemic lupus erythematosus (SLE) is still appreciable. In 1964, Kellum and Haserick (2) EUGENE V. BARNETT(3) noted 54 (36%) deaths in 150 patients who were followed prospectively for an 8-year period. Dubois et a1 (4) in 1974 reported 249 (51%) deaths among 491 patients who were followed for 13 years. Renal disease was the most common cause of death in the latter two series. Mortality rates and causes of death reflect in part the nature of each center's patient population. In order to more accurately describe the causes of death among SLE patients treated at university-affiliated centers in the United States, we have studied the causes of death in more than 4,000 patient-years of followup of 1,103 patients with SLE who were seen by members of the Lupus Survival Study Group (5).

In 1999, many of our Private Equity clients were struggling with the spiraling valuation levels of Internet and e-business entities. It was then L.E.K. first published this article and the three Internet firms were analyzed. Ten months later, the volatile stock prices of Amazon.com, eBay, and Yahoo! are down 62%, 28% and 66% respectively.The results published in this article were a snapshot in time and are less applicable after the corrections of 2000. However, it is interesting to note that the market has agreed with our findings. The point now, as it was a year ago, is not to challenge market valuations, but rather to emphasize the importance of identifying the key drivers of value and understanding the long-term performance expectations implied in valuations.

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