Women with systemic lupus erythematosus (SLE) in the U.S. live on average 22 years less — and men an average of 12 fewer years — than members of the same sex among the public at large, according to new data from Stanford University.
Leading causes of death for female SLE patients were septicemia (blood infections or blood poisoning) and hypertension, while male patients more often died of complications of heart disease and diabetes.
The study, “Impact of Sex on Systemic Lupus Erythematosus-Related Causes of Premature Mortality in the United States,” was published in the Journal of Women’s Health.
Lupus is an auto-immune disease associated with lesser life expectancy, but little is known about the causes of death associated with the disease, specially through a sex-based lens.
“This study examines the sex-based differences in the causes of death among women and men with SLE in the U.S. and identifies clinically relevant comorbidities, such as infectious diseases, that are more likely to contribute to premature death in this population,” Susan G. Kornstein, MD, editor-in-chief of Journal of Women’s Health, and executive director of the Virginia Commonwealth University Institute for Women’s Health, said in a press release.
Researchers at the Stanford School of Medicine investigated these causes among lupus patients using the 2014 national death certificate database, which includes 2.7 million death records in the U.S.
Among the 2,036 lupus patients in the database, 86.2 percent were women. While the median age at death for women in the general population was 81 years, it was 59 for those with lupus, a median difference of 22 years.
In men that difference was lesser. Male patients with lupus lived a median of 61 years, and those in the public at large to age 73, a median 12-year difference.
While septicemia and hypertension were the leading causes of death in women with SLE in general, those age 50 or younger were most likely to die of chronic renal failure and coagulation and hemorrhagic disorders. Among U.S. women without SLE, leading causes of death were dementias and acute cerebrovascular disease.
Among men in the general population, main causes of death were injury or poisoning, chronic obstructive pulmonary disease and dementias, and heart disease and diabetes in those with SLE. Among male SLE patients age 50 or younger, blood disorders (coagulation and hemorrhagic disorders) and chronic renal failure were top causes of earlier death.
Overall, “our findings reinforce the urgent need for interventions that reduce morbidity and mortality in patients with SLE to improve health outcomes and ultimately reduce health disparities,” the researchers wrote.
“These results identified clinically relevant comorbidities that need to be considered more carefully in the course of patients’ clinical management and the natural history of SLE disease, elucidating future targets for the investigation of sex based differences,” they added.