Association of the Charlson comorbidity index with mortality in systemic lupus erythematosus
Abstract
Objective: To investigate whether comorbidity as assessed by the Charlson Comorbidity Index (CCI) is associated with mortality in a long‐term followup of systemic lupus erythematosus (SLE) patients. Methods: Data were collected from 499 SLE patients attending the Lupus Clinic at the McGill University Health Center, Montreal, Quebec, Canada, and 170 SLE patients from the Department of Rheumatology at Lund University Hospital, Lund, Sweden. This included data on comorbidity, demographics, disease activity, the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SDI), and antiphospholipid antibody syndrome (APS). Variables were entered into a Cox proportional hazards survival model. Results: Mortality risk in the Montreal cohort was associated with the CCI (hazard ratio [HR] 1.57 per unit increase in the CCI, 95% confidence interval [95% CI] 1.18–2.09) and age (HR 1.04 per year increase in age, 95% CI 1.00–1.09). The CCI and age at diagnosis were also associated with mortality in the Lund cohort (CCI: HR 1.35, 95% CI 1.13–1.60; age: HR 1.09, 95% CI 1.05–1.12). Furthermore, the SDI was associated with mortality in the Lund cohort (HR 1.40, 95% CI 1.19–1.64), while a wide CI for the estimate in the Montreal cohort prevented a definitive conclusion (HR 1.20, 95% CI 0.97–1.48). We did not find a strong association between mortality and sex, race/ethnicity, disease activity, or APS in either cohort. Conclusion: In this study, comorbidity as measured by the CCI was associated with decreased survival independent of age, lupus disease activity, and damage. This suggests that the CCI may be useful in capturing comorbidity for clinical research in SLE.
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Comparing patients who used hydroxychloroquine with those who did not, no differences were found in demographics, disease duration, Charlson Comorbidity Score, or medications.
“When we compared patients on HCQ (HCQ+) with patients not on HCQ (HCQ−), no differences were observed with respect to demographics, disease duration, Charlson Co-morbidity Score (11), or medications.”
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- Authors
- Jönsen, A., Clarke, A. E., Joseph, L., Belisle, P., Bernatsky, S., Nived, O., Bengtsson, A. A., Sturfelt, G., & Pineau, C. A.
- Affiliations
- Lund University (SE)
- McGill University Health Centre (CA)
- Venue
- Arthritis Care & Research
- Publisher
- Wiley
- Published
- 2011-08-29
- Volume
- 63
- Issue
- 9
- Pages
- 1233-1237
- ISSN
- 0893-7524 (ISSN-L)
- 2151-464X
- 2151-4658
- OpenAlex
- W1967203954
- Cited by
- 49
- References
- 30
- Citations by year
- 2026: 1 · 2025: 6 · 2024: 1 · 2023: 1 · 2022: 4 · 2021: 3 · 2020: 5 · 2019: 3 · 2018: 3 · 2017: 5 · 2016: 3 · 2015: 3 · 2014: 5 · 2013: 3 · 2012: 3
- FWCI
- 2.56
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Arthritis Care & Research (publishedVersion)
- PubMed (publishedVersion)
- Lund University Publications (Lund University) (submittedVersion)
- Topics
- Health Sciences › Medicine › Rheumatology › Systemic Lupus Erythematosus Research
- Health Sciences › Medicine › Pathology and Forensic Medicine › Systemic Sclerosis and Related Diseases
- Health Sciences › Medicine › Epidemiology › Chronic Disease Management Strategies
- Keywords
- systemic lupus erythematosus, Charlson Comorbidity Index, comorbidities, mortality, survival, antiphospholipid syndrome, disease activity, age at diagnosis
- MeSH terms
- Adolescent, Adult, Aged, Aged, 80 and over, Child, Female, Follow-Up Studies, Health Status Indicators, Humans, Lupus Erythematosus, Systemic, Male, Middle Aged, Prognosis, Prospective Studies, Quebec, Risk Factors, Sweden, Time Factors, Comorbidity, Proportional Hazards Models, Risk Assessment, Young Adult
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