CAUSA DE MORTALIDADE DE PACIENTES COM LÚPUS ERITEMATOSO SISTÊMICO NO HOSPITAL DAS CLÍNICAS DE GOIÁS (HC-UFG)
Autor(a) principal: | |
---|---|
Data de Publicação: | 2023 |
Outros Autores: | , , , , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | por |
Título da fonte: | Brazilian Journal of Implantology and Health Sciences |
Texto Completo: | https://bjihs.emnuvens.com.br/bjihs/article/view/1113 |
Resumo: | Systemic Lupus Erythematosus (SLE) is a chronic and systemic inflammatory autoimmune disease, with periods of exacerbation and remission, with variable symptoms, laboratory findings and prognosis. There has been an improvement in 10-year survival for patients with SLE over the past 5 decades, however SLE mortality rates remain high when compared to the general population, which is due to disease activity, treatment complications, infections or other factors. chronic comorbidities. This study aimed to describe and discuss the main cause of death and aspects sociodemographic, clinical and laboratory manifestations of patients with SLE at the Hospital das Clínicas of the Faculty of Medicine of the Federal University of Goiás (HC-UFG) and compare them with data from the literature. A retrospective, descriptive and observational study of patients with SLE who died at the HC-UFG between January 2005 and October 2019 was performed. 39 medical records were analyzed, of which 28 were validated after the exclusion criteria. DataSUS data were also collected on SLE mortality in the Midwest region in the same period for comparison. Student's T-test was used in the sociodemographic comparison between patients from the Midwest Region and patients included in the current study. Values were considered statistically significant when p<0.05. During the period, 651 patients were hospitalized with SLE in the period described, of which 28 died, with a mortality rate of 4.3%. Twenty-six (92.8%) were female and 2 (7.1%) were male. The average age at death was 35 ± 15.69 years, with the most affected age group being between 20 and 29 years. DataSUS data revealed 78 deaths from SLE in the Midwest region in the period, and there was no statistical difference for sex, age and ethnicity when compared to the sample at HC-UFG. The mean age at diagnosis was 28.2 ± 13.37 years, ranging from 8 years to 69 years, and the mean time from diagnosis to death was 93.11 ± 107 months, ranging from 3 days to 24 years. The main clinical manifestations were arthralgia, arthritis, renal involvement, hematological changes and malar erythema. The main laboratory findings in the patients were Antinuclear Antibodies (ANA), Rheumatoid Factor, AntiRo, Anti-DNA and low C3 and C4. The main drugs used by the patients were corticosteroids, hydroxychloroquine, pulse therapy with solumedrol and cyclophosphamide. At death, the main manifestations of the disease were hematological and renal. The main cause of death was infection, in 26 (92.8%) patients, all with sepsis, and 17 underwent procedures that predispose to infection. The other causes of death included 1 AMI and 1 due to disease activity. Mortality from SLE in the study was 4.3% and the main cause of death was infection, such as the presence of hematological and renal activity. With better control of disease activity, there has been an increase in deaths from infection, and measures are needed to improve the survival of patients with SLE, such as the judicious use of immunosuppressants and corticosteroids, encouraging vaccination and less exposure to risk situations as invasive procedures. |
id |
GOE-1_5cccef2fab2a89318c3960c3f229926a |
---|---|
oai_identifier_str |
oai:ojs.bjihs.emnuvens.com.br:article/1113 |
network_acronym_str |
GOE-1 |
network_name_str |
Brazilian Journal of Implantology and Health Sciences |
repository_id_str |
|
spelling |
CAUSA DE MORTALIDADE DE PACIENTES COM LÚPUS ERITEMATOSO SISTÊMICO NO HOSPITAL DAS CLÍNICAS DE GOIÁS (HC-UFG)Lúpus Eritematoso SistêmicoLESInfecçãoMortalidadeSystemic Lupus ErythematosusSLEinfectionMortalitySystemic Lupus Erythematosus (SLE) is a chronic and systemic inflammatory autoimmune disease, with periods of exacerbation and remission, with variable symptoms, laboratory findings and prognosis. There has been an improvement in 10-year survival for patients with SLE over the past 5 decades, however SLE mortality rates remain high when compared to the general population, which is due to disease activity, treatment complications, infections or other factors. chronic comorbidities. This study aimed to describe and discuss the main cause of death and aspects sociodemographic, clinical and laboratory manifestations of patients with SLE at the Hospital das Clínicas of the Faculty of Medicine of the Federal University of Goiás (HC-UFG) and compare them with data from the literature. A retrospective, descriptive and observational study of patients with SLE who died at the HC-UFG between January 2005 and October 2019 was performed. 39 medical records were analyzed, of which 28 were validated after the exclusion criteria. DataSUS data were also collected on SLE mortality in the Midwest region in the same period for comparison. Student's T-test was used in the sociodemographic comparison between patients from the Midwest Region and patients included in the current study. Values were considered statistically significant when p<0.05. During the period, 651 patients were hospitalized with SLE in the period described, of which 28 died, with a mortality rate of 4.3%. Twenty-six (92.8%) were female and 2 (7.1%) were male. The average age at death was 35 ± 15.69 years, with the most affected age group being between 20 and 29 years. DataSUS data revealed 78 deaths from SLE in the Midwest region in the period, and there was no statistical difference for sex, age and ethnicity when compared to the sample at HC-UFG. The mean age at diagnosis was 28.2 ± 13.37 years, ranging from 8 years to 69 years, and the mean time from diagnosis to death was 93.11 ± 107 months, ranging from 3 days to 24 years. The main clinical manifestations were arthralgia, arthritis, renal involvement, hematological changes and malar erythema. The main laboratory findings in the patients were Antinuclear Antibodies (ANA), Rheumatoid Factor, AntiRo, Anti-DNA and low C3 and C4. The main drugs used by the patients were corticosteroids, hydroxychloroquine, pulse therapy with solumedrol and cyclophosphamide. At death, the main manifestations of the disease were hematological and renal. The main cause of death was infection, in 26 (92.8%) patients, all with sepsis, and 17 underwent procedures that predispose to infection. The other causes of death included 1 AMI and 1 due to disease activity. Mortality from SLE in the study was 4.3% and the main cause of death was infection, such as the presence of hematological and renal activity. With better control of disease activity, there has been an increase in deaths from infection, and measures are needed to improve the survival of patients with SLE, such as the judicious use of immunosuppressants and corticosteroids, encouraging vaccination and less exposure to risk situations as invasive procedures.O Lúpus Eritematoso Sistêmico (LES) é uma doença autoimune inflamatória crônica e sistêmica, apresenta períodos de exacerbação e de remissão, com sintomatologia, achados laboratoriais e prognósticos variáveis. Houve melhoria na sobrevida em 10 anos para pacientes com LES nas últimas 5 décadas, entratanto as taxas de mortalidade por LES permanecem alta quando comparadas às da população em geral, o que ocorre devido à atividade da doença, complicações do tratamento, infecções ou a fatores crônicos de comorbidades. Este estudo teve como objetivo descrever e discutir a principal causa de óbito e aspectos sociodemográficos, manifestações clínicas e laboratoriais dos pacientes com LES no Hospital das Clínicas da Faculdade de Medicina da Universidade Federal de Goiás (HC-UFG) e comparálos com dados da literatura. Foi realizado um estudo retrospectivo, descritivo e observacional dos pacientes com LES que foram a óbito no HC-UFG entre janeiro de 2005 a outubro de 2019. Foram analisados 39 prontuários, dos quais 28 foram validados após os critérios de exclusão. Também coletou-se dados do DataSUS sobre a mortalidade por LES na região Centro-Oeste no mesmo período para comparação. O teste t de Student foi utilizado na comparação sociodemográfica entre pacientes da Região Centro-Oeste e pacientes do estudo. Os valores foram considerados estatisticamente significativos quando p<0,05. O número de paciente internados por LES no perído foi de 651, dos quais 28 vieram a óbito, com taxa de mortalidade de 4,3%. Vinte e seis (92,8%) eram do sexo feminino e 2 (7,1%) do sexo masculino. A média de idade ao óbito foi de 35 ± 15,69 anos, sendo a faixa etária mais acometida a de 20 a 29 anos. Dados do DataSUS revelaram 78 mortes por LES na região Centro-Oeste no período, e não houve diferença estatistica para sexo, idade e etnia quando comparado com a amostra no HC-UFG. A idade média ao diagnóstico foi de 28,2 ± 13,37 anos, variando de 8 anos a 69 anos, e o tempo médio entre diagnóstico até o óbito foi de 93,11 ± 107 meses, variando de 3 dias a 24 anos. As principais manifestações clínicas foram artralgia, artrite, acometimentos renais, alterações hematológicas e eritema malar. Os principais achados laboratoriais nos pacientes foram fator antinuclear (FAN), fator reumatoide, anti-Ro, anti-DNA e C3 e C4 baixos. Os principais fármacos utilizados foram corticoide, hidroxicloroquina, pulsoterapia com solumedrol e com ciclofosfamida. No óbito, as principais manifestações da doença eram hematológicas e renais. A principal causa de óbito foi infecção, em 26 (92,8%) pacientes, todos como sepse, sendo que 17 realizaram procedimentos que predispõem a infecção. As outras causas de óbito incluíram 1 IAM e 1 por atividade da doença. A mortalidade por LES no estudo foi de 4,3% e a principal causa de óbito foi infecção, como a presença de atividade hematológica e renal. Com o melhor controle da atividade da doença, houve um aumento de mortes por infecção, e medidas são necessárias para melhorar a sobrevida dos pacientes com LES, como o uso criterioso dos imunossupressores e corticoides, o incentivo a vacinação e menor exposição à situação de risco como procedimentos invasivos.Specialized Dentistry Group2023-12-20info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://bjihs.emnuvens.com.br/bjihs/article/view/111310.36557/2674-8169.2023v5n5p5928-5946Brazilian Journal of Implantology and Health Sciences ; Vol. 5 No. 5 (2023): BJIHS QUALIS B3; 5928-5946Brazilian Journal of Implantology and Health Sciences ; Vol. 5 Núm. 5 (2023): BJIHS QUALIS B3; 5928-5946Brazilian Journal of Implantology and Health Sciences ; v. 5 n. 5 (2023): BJIHS QUALIS B3; 5928-59462674-8169reponame:Brazilian Journal of Implantology and Health Sciencesinstname:Grupo de Odontologia Especializada (GOE)instacron:GOEporhttps://bjihs.emnuvens.com.br/bjihs/article/view/1113/1270Copyright (c) 2023 Jaime Garcia Pereira Neto, Vinicius Catenassi Pereira Santos , Vinícius Sousa Santana , Arthur Gomes Pidde, Paula Beatriz de Barros Ribeiro, Lais Martins Queiroz, Diandra Cavalcante de Oliveira, Rafael Caetano Ataides, Celso Gonçalves de Castro Filho , Renato Gomes Castro, Vitalina de Sousa Barbosa, Gabrielle Pereira Silvahttps://creativecommons.org/licenses/by/4.0info:eu-repo/semantics/openAccessPereira Neto, Jaime GarciaCatenassi Pereira Santos , ViniciusSousa Santana , ViníciusGomes Pidde, Arthurde Barros Ribeiro, Paula BeatrizMartins Queiroz, LaisCavalcante de Oliveira, DiandraCaetano Ataides, RafaelGonçalves de Castro Filho , CelsoGomes Castro, Renatode Sousa Barbosa, VitalinaPereira Silva, Gabrielle2023-12-20T17:03:33Zoai:ojs.bjihs.emnuvens.com.br:article/1113Revistahttps://bjihs.emnuvens.com.br/bjihsONGhttps://bjihs.emnuvens.com.br/bjihs/oaijournal.bjihs@periodicosbrasil.com.br2674-81692674-8169opendoar:2023-12-20T17:03:33Brazilian Journal of Implantology and Health Sciences - Grupo de Odontologia Especializada (GOE)false |
dc.title.none.fl_str_mv |
CAUSA DE MORTALIDADE DE PACIENTES COM LÚPUS ERITEMATOSO SISTÊMICO NO HOSPITAL DAS CLÍNICAS DE GOIÁS (HC-UFG) |
title |
CAUSA DE MORTALIDADE DE PACIENTES COM LÚPUS ERITEMATOSO SISTÊMICO NO HOSPITAL DAS CLÍNICAS DE GOIÁS (HC-UFG) |
spellingShingle |
CAUSA DE MORTALIDADE DE PACIENTES COM LÚPUS ERITEMATOSO SISTÊMICO NO HOSPITAL DAS CLÍNICAS DE GOIÁS (HC-UFG) Pereira Neto, Jaime Garcia Lúpus Eritematoso Sistêmico LES Infecção Mortalidade Systemic Lupus Erythematosus SLE infection Mortality |
title_short |
CAUSA DE MORTALIDADE DE PACIENTES COM LÚPUS ERITEMATOSO SISTÊMICO NO HOSPITAL DAS CLÍNICAS DE GOIÁS (HC-UFG) |
title_full |
CAUSA DE MORTALIDADE DE PACIENTES COM LÚPUS ERITEMATOSO SISTÊMICO NO HOSPITAL DAS CLÍNICAS DE GOIÁS (HC-UFG) |
title_fullStr |
CAUSA DE MORTALIDADE DE PACIENTES COM LÚPUS ERITEMATOSO SISTÊMICO NO HOSPITAL DAS CLÍNICAS DE GOIÁS (HC-UFG) |
title_full_unstemmed |
CAUSA DE MORTALIDADE DE PACIENTES COM LÚPUS ERITEMATOSO SISTÊMICO NO HOSPITAL DAS CLÍNICAS DE GOIÁS (HC-UFG) |
title_sort |
CAUSA DE MORTALIDADE DE PACIENTES COM LÚPUS ERITEMATOSO SISTÊMICO NO HOSPITAL DAS CLÍNICAS DE GOIÁS (HC-UFG) |
author |
Pereira Neto, Jaime Garcia |
author_facet |
Pereira Neto, Jaime Garcia Catenassi Pereira Santos , Vinicius Sousa Santana , Vinícius Gomes Pidde, Arthur de Barros Ribeiro, Paula Beatriz Martins Queiroz, Lais Cavalcante de Oliveira, Diandra Caetano Ataides, Rafael Gonçalves de Castro Filho , Celso Gomes Castro, Renato de Sousa Barbosa, Vitalina Pereira Silva, Gabrielle |
author_role |
author |
author2 |
Catenassi Pereira Santos , Vinicius Sousa Santana , Vinícius Gomes Pidde, Arthur de Barros Ribeiro, Paula Beatriz Martins Queiroz, Lais Cavalcante de Oliveira, Diandra Caetano Ataides, Rafael Gonçalves de Castro Filho , Celso Gomes Castro, Renato de Sousa Barbosa, Vitalina Pereira Silva, Gabrielle |
author2_role |
author author author author author author author author author author author |
dc.contributor.author.fl_str_mv |
Pereira Neto, Jaime Garcia Catenassi Pereira Santos , Vinicius Sousa Santana , Vinícius Gomes Pidde, Arthur de Barros Ribeiro, Paula Beatriz Martins Queiroz, Lais Cavalcante de Oliveira, Diandra Caetano Ataides, Rafael Gonçalves de Castro Filho , Celso Gomes Castro, Renato de Sousa Barbosa, Vitalina Pereira Silva, Gabrielle |
dc.subject.por.fl_str_mv |
Lúpus Eritematoso Sistêmico LES Infecção Mortalidade Systemic Lupus Erythematosus SLE infection Mortality |
topic |
Lúpus Eritematoso Sistêmico LES Infecção Mortalidade Systemic Lupus Erythematosus SLE infection Mortality |
description |
Systemic Lupus Erythematosus (SLE) is a chronic and systemic inflammatory autoimmune disease, with periods of exacerbation and remission, with variable symptoms, laboratory findings and prognosis. There has been an improvement in 10-year survival for patients with SLE over the past 5 decades, however SLE mortality rates remain high when compared to the general population, which is due to disease activity, treatment complications, infections or other factors. chronic comorbidities. This study aimed to describe and discuss the main cause of death and aspects sociodemographic, clinical and laboratory manifestations of patients with SLE at the Hospital das Clínicas of the Faculty of Medicine of the Federal University of Goiás (HC-UFG) and compare them with data from the literature. A retrospective, descriptive and observational study of patients with SLE who died at the HC-UFG between January 2005 and October 2019 was performed. 39 medical records were analyzed, of which 28 were validated after the exclusion criteria. DataSUS data were also collected on SLE mortality in the Midwest region in the same period for comparison. Student's T-test was used in the sociodemographic comparison between patients from the Midwest Region and patients included in the current study. Values were considered statistically significant when p<0.05. During the period, 651 patients were hospitalized with SLE in the period described, of which 28 died, with a mortality rate of 4.3%. Twenty-six (92.8%) were female and 2 (7.1%) were male. The average age at death was 35 ± 15.69 years, with the most affected age group being between 20 and 29 years. DataSUS data revealed 78 deaths from SLE in the Midwest region in the period, and there was no statistical difference for sex, age and ethnicity when compared to the sample at HC-UFG. The mean age at diagnosis was 28.2 ± 13.37 years, ranging from 8 years to 69 years, and the mean time from diagnosis to death was 93.11 ± 107 months, ranging from 3 days to 24 years. The main clinical manifestations were arthralgia, arthritis, renal involvement, hematological changes and malar erythema. The main laboratory findings in the patients were Antinuclear Antibodies (ANA), Rheumatoid Factor, AntiRo, Anti-DNA and low C3 and C4. The main drugs used by the patients were corticosteroids, hydroxychloroquine, pulse therapy with solumedrol and cyclophosphamide. At death, the main manifestations of the disease were hematological and renal. The main cause of death was infection, in 26 (92.8%) patients, all with sepsis, and 17 underwent procedures that predispose to infection. The other causes of death included 1 AMI and 1 due to disease activity. Mortality from SLE in the study was 4.3% and the main cause of death was infection, such as the presence of hematological and renal activity. With better control of disease activity, there has been an increase in deaths from infection, and measures are needed to improve the survival of patients with SLE, such as the judicious use of immunosuppressants and corticosteroids, encouraging vaccination and less exposure to risk situations as invasive procedures. |
publishDate |
2023 |
dc.date.none.fl_str_mv |
2023-12-20 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://bjihs.emnuvens.com.br/bjihs/article/view/1113 10.36557/2674-8169.2023v5n5p5928-5946 |
url |
https://bjihs.emnuvens.com.br/bjihs/article/view/1113 |
identifier_str_mv |
10.36557/2674-8169.2023v5n5p5928-5946 |
dc.language.iso.fl_str_mv |
por |
language |
por |
dc.relation.none.fl_str_mv |
https://bjihs.emnuvens.com.br/bjihs/article/view/1113/1270 |
dc.rights.driver.fl_str_mv |
https://creativecommons.org/licenses/by/4.0 info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
https://creativecommons.org/licenses/by/4.0 |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Specialized Dentistry Group |
publisher.none.fl_str_mv |
Specialized Dentistry Group |
dc.source.none.fl_str_mv |
Brazilian Journal of Implantology and Health Sciences ; Vol. 5 No. 5 (2023): BJIHS QUALIS B3; 5928-5946 Brazilian Journal of Implantology and Health Sciences ; Vol. 5 Núm. 5 (2023): BJIHS QUALIS B3; 5928-5946 Brazilian Journal of Implantology and Health Sciences ; v. 5 n. 5 (2023): BJIHS QUALIS B3; 5928-5946 2674-8169 reponame:Brazilian Journal of Implantology and Health Sciences instname:Grupo de Odontologia Especializada (GOE) instacron:GOE |
instname_str |
Grupo de Odontologia Especializada (GOE) |
instacron_str |
GOE |
institution |
GOE |
reponame_str |
Brazilian Journal of Implantology and Health Sciences |
collection |
Brazilian Journal of Implantology and Health Sciences |
repository.name.fl_str_mv |
Brazilian Journal of Implantology and Health Sciences - Grupo de Odontologia Especializada (GOE) |
repository.mail.fl_str_mv |
journal.bjihs@periodicosbrasil.com.br |
_version_ |
1796798442321739776 |