Single-center Study On The Relationship Between Age-adjusted Charlson Comorbidity Index And Organ Damage In Patients With Systemic Lupus Erythematosus

【Objective】 Research the relationship between comorbidities and organ damage in patients with systemic lupus erythematosus(SLE)in a single center,and to investigate the prognosis and individual management strategies of sle patients with comorbidities.【Methods】This study retrospectively analyzed the relationship between demographic,work,and social information of 523 patients with systemic lupus erythematosus who were continuously hospitalized in the department of rheumatology,Second affiliated hospital of Fujian medical university from October 2013 to March 2018,and the age-adjusted charleson comorbidities index and disease characteristics.The evaluation analysis includes the correlation between the comorbidity characteristics,gender,Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index(SDI),ACCI scores and 10-year prognostic survival rate of patients with systemic lupus erythematosus,and finally discusses the individualized treatment decision.【Results】1.The main comorbidities of systemic lupus erythematosus inpatients are gender-related: male patients with pulmonary infection(male 38.3% vs female 15.8%,P= 0.001),hypertension(33.3% vs 6.4%,P = 0.004),pleural effusion(25% vs 13.6%,P= 0.032),pulmonary hypertension(31.7% vs 11%,P <0.01),heart valve disease(18.3%vs 9.1%,P = 0.038),pulmonary interstitial fibrosis(3.3% vs 8.4%,P = 0.001),liver dysfunction(20% vs 8.4%,P = 0.009)have a higher incidence of complications than female patients.The incidence of SLE major comorbidities associated with age: the comorbid rate of pulmonary infection,hypertension,sjogren’s syndrome and pulmonary interstitial fibrosis in middle-aged and elderly SLE patients is higher than that in young SLE patients(P < 0.05),and the comorbid rate of pulmonary hypertension,pleural effusion and heart valve diseases in middle-aged SLE patients is higher than that in young SLE patients(P < 0.01).2.The score and ratio of ACCI in 523 SLE patients were: ACCI≤2 points,81.5%(426/523),ACCI between 3 and 4 points,16.3%(85/523),and ACCI≥5 points,2.2%(12/523).Moreover,there were gender differences in the distribution of ACCI in SLE patients(2.17±1.42 for males vs.1.27±1.28 for females,P < 0.01).3.There was no correlation between ACCI and Systemic Lupus Erythematosus Disease Activity Index 2000(SLEDAI-2000)in SLE patients(r=0.067,P=0.129).The ACCI score of SLE patients with organ damage group was higher than that of the non-organ damage group(Z=-4.88,P < 0.01).4.In SLE patients with organ damage,the 10-year survival rate is reduced.The 10-year survival rate was affected by the anti-nuclear antibody,anti-ssa antibody positive rate and CRP,as well as the length of education and BMI(P < 0.05).【Conclusion】The comorbidity distribution of systemic lupus erythematosus showed sex disparity.With the increase of age,the number of comorbidity clusters and the ACCI score also increased.The association between ACCI score of SLE patients and the Systemic lupus erythematosus disease activity index was not observed in this study,but is related to the SLICC / ACR injury index.Analyzing the distribution characteristics and influencing factors of ACCI scores in SLE patients,it provides evidence for clinical decision-making for individualized management of patients.