Systemic Lupus International Collaborating Clinics Frailty Index predicts mortality in systemic lupus erythematosus patients: data from the Almenara Lupus Cohort.

IF 4.2 2区医学 Q1 RHEUMATOLOGY

Lupus Science & Medicine Pub Date : 2026-06-12 DOI:10.1136/lupus-2025-001938

Benny Harold Rashuamán-Conche, Rocio Violeta Gamboa-Cárdenas, Victor Román Pimentel-Quiroz, Anubhav Singh, Cristina Reátegui-Sokolova, Claudia Elera-Fitzcarrald, Samira Garcia-Hirsh, Cesar Pastor-Asurza, Zoila Rodríguez-Bellido, Risto Alfredo Perich-Campos, Graciela S Alarcón, Manuel Francisco Ugarte-Gil

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引用次数: 0

Abstract

Objective: Frailty has been shown to predict damage accrual in patients with systemic lupus erythematosus (SLE), including those from Latin America. However, the impact of frailty on mortality has been scarcely evaluated, particularly in Latin American populations. The aim of this study was to evaluate frailty as a predictor of mortality in Latin American SLE patients.

Methods: Patients from a single-centre 2012-2025 prevalent cohort were studied. Mortality was defined as the vital status according to the Peruvian Department of Health. Frailty was ascertained using the Systemic Lupus International Collaborating Clinics Frailty Index (SLICC-FI) as a continuous variable. Univariable and multivariable Cox regression models were done to estimate its impact on mortality. Multivariable models were adjusted for possible confounders. Sensitivity analyses were performed including data up to March 2020 to avoid the potential influence of the COVID-19 pandemic. Additionally, a Kaplan-Meier curve was calculated by frail status (frail, SLICC-FI >0.21; non-frail, SLICC-FI ≤0.21).

Results: Four hundred and ninety-five patients were included, 456 (92.1%) were women and 96 (19.4%) were frail. Their mean (SD) age at diagnosis was 35.0 (14.0) years, their mean disease duration at baseline was 6.7 (6.1) years and their mean follow-up time was 8.5 (4.2) years. Fifty-six (11.3%) patients died during the follow-up. The SLICC-FI predicted mortality even after adjusting for possible confounders (hazard ratio (HR)=1.54 (CI 95% 1.11 to 2.14), p=0.010). This prediction capability remained on the sensitivity analyses (HR 1.85; (95% CI 1.30 to 2.61), p<0.001).

Conclusion: Frailty, as ascertained with the SLICC-FI, was a predictor of mortality in a Latin American cohort of SLE patients. Frailty could be considered in the monitoring of SLE patients; possible interventions to modify it should be developed.

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系统性红斑狼疮国际合作诊所虚弱指数预测系统性红斑狼疮患者的死亡率：来自Almenara狼疮队列的数据。

目的：虚弱已被证明可以预测系统性红斑狼疮（SLE）患者的损伤累积，包括来自拉丁美洲的患者。然而，很少评估虚弱对死亡率的影响，特别是在拉丁美洲人口中。本研究的目的是评估虚弱作为拉丁美洲SLE患者死亡率的预测因子。方法：对2012-2025年流行队列的单中心患者进行研究。秘鲁卫生部将死亡率定义为生命状态。虚弱被确定使用系统性狼疮国际合作诊所虚弱指数（SLICC-FI）作为一个连续变量。采用单变量和多变量Cox回归模型估计其对死亡率的影响。针对可能的混杂因素对多变量模型进行了调整。对截至2020年3月的数据进行敏感性分析，以避免COVID-19大流行的潜在影响。此外，根据虚弱状态计算Kaplan-Meier曲线（虚弱，SLICC-FI >0.21；非虚弱，SLICC-FI≤0.21）。结果：共纳入495例患者，其中女性456例（92.1%），体弱96例（19.4%）。诊断时的平均（SD）年龄为35.0（14.0）岁，基线时的平均病程为6.7（6.1）年，平均随访时间为8.5（4.2）年。56例（11.3%）患者在随访期间死亡。SLICC-FI即使在调整了可能的混杂因素后也能预测死亡率(风险比（HR)=1.54 (CI 95% 1.11 ~ 2.14), p=0.010）。在敏感性分析中，这种预测能力仍然存在（HR 1.85; 95% CI 1.30 - 2.61）。结论：在拉丁美洲SLE患者队列中，SLICC-FI确定的虚弱是死亡率的预测因子。在监测SLE患者时可考虑体弱多病；应该制定可能的干预措施来修改它。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Lupus Science & Medicine RHEUMATOLOGY-

CiteScore

5.30

自引率

7.70%

发文量

审稿时长

15 weeks

期刊介绍： Lupus Science & Medicine is a global, peer reviewed, open access online journal that provides a central point for publication of basic, clinical, translational, and epidemiological studies of all aspects of lupus and related diseases. It is the first lupus-specific open access journal in the world and was developed in response to the need for a barrier-free forum for publication of groundbreaking studies in lupus. The journal publishes research on lupus from fields including, but not limited to: rheumatology, dermatology, nephrology, immunology, pediatrics, cardiology, hepatology, pulmonology, obstetrics and gynecology, and psychiatry.