Systemic Lupus Erythematosus Linked to Higher Risk of Respiratory Failure

Patients with systemic lupus erythematosus (SLE) may be at increased risk of incident respiratory failure, according to a nationwide study by Taiwanese researchers.

The study, “Effect of Systemic Lupus Erythematosus on the Risk of Incident Respiratory Failure: A National Cohort Study,” published in the journal PLoS One, also suggests that, among SLE patients, those who receive frequent medical assistance are at highest risk, and particularly men.

SLE is an autoimmune disease that affects multiple organs, including the lungs, and has been associated with an increased risk of incident lung diseases, such as pneumonia or pulmonary embolism. In turn, these complications can lead to the loss of respiratory function by promoting the development of chronic obstructive pulmonary disease (COPD) or acute/chronic respiratory failure, even in SLE patients without other health issues.

To confirm that SLE is indeed associated with a higher risk of lung diseases, or may promote the progression of other existing airway pathologies, contributing to incident respiratory failure, the researchers used the Taiwan’s National Health Insurance Research Database (from 1997 to 2011) to identify SLE patients across the country and evaluate the incidence of respiratory failure.

The study included 11,533 patients who had been newly diagnosed with SLE and 46,132 healthy subjects, with matching age, gender, and number of medical visits per year.

“This study revealed that regardless of age, sex, or pre-existing comorbidities, the incidence of incident respiratory failure was higher in the SLE cohort than in the non-SLE cohort,” the researchers wrote. “SLE patients older than 65 years of age exhibited a higher incidence of incident respiratory failure, which is in contrast to the poor prognosis of young women reported in a previous study.

“A possible explanation may be that older patients in the SLE and non-SLE cohorts tended to have more primary complications, such as cardiovascular and pulmonary lesions, resulting from the primary deterioration of the patients in the SLE cohort; these primary complications may be risk factors for the onset of incident respiratory failure among older adults.”

Researchers also noticed that, among SLE patients, those who frequently receive medical services, especially men, exhibited a higher risk of incident respiratory failure. This complication was also more frequent in patients with SLE without additional health conditions, than in non-SLE patients with other diseases.

“This study determined that patients with SLE are associated with an increased risk of incident respiratory failure, regardless of age, sex, and pre-existing comorbidities; this increased risk is particularly pronounced among patients who frequently receive medical services,” they concluded.