الفهرس 
Survival and disease related comorbidities Among egyptian patients with systemic Lupus erythematosus
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Abstract
Objective: The study was conducted to describe the survival, comorbidities and mortality-related profile in Egyptian patients with systemic lupus erythematosus (SLE). Methods: The medical records of 202 patients diagnosed with SLE, fulfilling the American College of Rheumatology 1997 SLE classification criteria who have been following up during the time period between 1999 and 2019 at the Department of Rheumatology and Rehabilitation, Kasr Al Ainy, were retrospectively reviewed. Demographic data, presenting and cumulative clinical features and comorbidities, and serial Systemic Lupus International Collaborating Clinics/American College of Rheumatology-Damage Index (SLICC/ACR-DI) damage scores were obtained. For patients who lost follow-up, data were censored at the last clinic visit. Survival over time was studied by the Kaplan-Meier method, and factors predictive of mortality were evaluated by the Cox regression analysis (univariate and multivariate) and univariate logistic regression analysis Results: Hypertension and infections needing systemic treatment were the most encountered complications affecting 56.9% and 75.5% of patients, respectively and the least reported complication was malignancy (0.5%). Survival at 5, 10, 15, 20 years was 82.9%, 68.8%, 51.4% and 20.4%, respectively and the most frequent causes of death were active SLE and sepsis. Using univariate analysis unfavorable factors for survival were use of cyclophosphamide, cumulative dose of methylprednisone and presence of lupus nephritis (LN) or neuropsychiatric lupus (NPSLE) as a clinical presentation during follow up. Patients who received cyclophosphamide were 4.6 times (HR=4.67, 95% CI =1.85-11.78, p=0.001) more likely to die than those who did not receive it and for every 1-gram increase in cumulative dose of IV methylprednisone there was a 10% increased risk for mortality (HR=1.1, 95% CI=1.049-1.165, p<0.001)