256 0

Prevalence, Risk Factors and Impact on Mortality of Neuropsychiatric Lupus

Title
Prevalence, Risk Factors and Impact on Mortality of Neuropsychiatric Lupus
Author
Ga Young Ahn
Alternative Author(s)
안가영
Advisor(s)
배상철
Issue Date
2019-02
Publisher
한양대학교
Degree
Master
Abstract
Objectives: This study aims to identify the prevalence, risk factors, and impact on mortality of neuropsychiatric systemic lupus erythematosus (NPSLE). Methods: Patients from the Hanyang BAE lupus cohort were registered and followed from 1998 to 2015. NPSLE was defined using American College of Rheumatology (ACR) case definitions and Ainiala Criteria. Demographics, autoantibodies, systemic lupus erythematosus disease activity index (SLEDAI), and Systemic lupus international collaborating clinic (SLICC)/ACR damage index were collected at baseline and then annually. Mortality data were derived by linking data from the Korean National Statistics Office. Multivariable logistic regression and cox regression analysis were conducted in the inception cohort to assess the risk factors and mortality impact of Ainiala NPSLE. Results: Of 1121 registered patients, 429 (38.3%) had NPSLE manifestations according to ACR criteria and 216 (19.3%) by Ainiala criteria. In multivariable logistic regression analysis, higher SLEDAI (OR 1.08, CI 1.01-1.16, p=0.02) and anti-phospholipid antibody positivity (OR 1.72, CI 1.03-2.87, p=0.04) at SLE diagnosis increased NPSLE risk, while elevated anti-dsDNA antibodies (OR 0.43, CI 0.24-0.78, p<0.01) and greater education duration (OR 0.92, CI 0.85-1.00, p=0.04) showed reduced risk of NPSLE. Cox proportional hazard models demonstrated that presence of NPSLE had a three-fold increased risk of mortality (HR 3.09, CI 1.03-9.21, p=0.04), especially in patients with focal CNS NPSLE (HR=7.83, CI 2.12-28.96, p<0.01). Conclusions: Higher SLEDAI, antiphospholipid antibody positivity, absence of anti-dsDNA antibody at SLE diagnosis, and fewer years of education are risk factors for development of NPSLE. Presence of NPSLE, especially focal CNS NPSLE, increased the risk of mortality in SLE patients.
URI
https://repository.hanyang.ac.kr/handle/20.500.11754/99586http://hanyang.dcollection.net/common/orgView/200000434683
Appears in Collections:
GRADUATE SCHOOL[S](대학원) > MEDICINE(의학과) > Theses (Master)
Files in This Item:
There are no files associated with this item.
Export
RIS (EndNote)
XLS (Excel)
XML


qrcode

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.

BROWSE