Mortality up in SLE patients a month after ischaemic stroke
Patients with systemic lupus erythematosus (SLE), compared to those without, have an increased risk of mortality after the first month following an ischaemic stroke, a recent study has found. In addition, functionality becomes poorer at 3 months.
To examine mortality and functionality impairment after stroke in SLE, researchers identified 423 patients with SLE and 1,652 individuals with SLE who developed a first-ever ischaemic or haemorrhagic stroke (1998 to 2013) using Swedish nationwide registers. Patients were followed for 1 year or until all-cause death.
Researchers then estimated the hazard ratio (HR) for death after ischaemic or haemorrhagic stroke and the risk ratio (RR) of functional impairment (dependence in either transferring, toileting or dressing) 3 months following ischaemic stroke.
Twenty-two percent of patients with SLE died a year after stroke compared with 16 percent of those without SLE. There was an increased risk of death for patients with SLE after ischaemic stroke (HR, 1.85; 95 percent CI, 1.39 to 2.45), which was attenuated after controlling for SLE-related comorbidities (HR, 1.41; 1.04 to 1.91).
Furthermore, functional impairment at 3 months increased by almost twofold in patients with SLE (RR, 1.73; 1.16 to 2.57). Those with SLE had an HR for death of 2.30 (1.38 to 3.82) following haemorrhagic stroke, which was elevated even during the first month.
“SLE is associated with all-cause death after haemorrhagic stroke even during the first month,” according to researchers, adding that there is a need for “a shift of focus to patient functionality and prevention of haemorrhagic strokes.”