CAUSA DE MORTALIDADE DE PACIENTES COM LÚPUS ERITEMATOSO SISTÊMICO NO HOSPITAL DAS CLÍNICAS DE GOIÁS (HC-UFG)

• Autor(a) principal: Pereira Neto, Jaime Garcia
• Data de Publicação: 2023
• Outros Autores: 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
• 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
• topic: Lúpus Eritematoso Sistêmico; LES; Infecção; Mortalidade; Systemic Lupus Erythematosus; SLE; infection; Mortality

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.