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Vol. 6. Issue 1.
Pages 11-15 (January - February 2010)
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Vol. 6. Issue 1.
Pages 11-15 (January - February 2010)
DOI: 10.1016/S2173-5743(10)70004-6
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Damage in Cuban patients with systemic lupus erythematosus. Relation with disease features
Daño en pacientes cubanos con lupus eritematoso sistémico. Relación con características de la enfermedad
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Miguel Estévez del Toro??
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mestevez@infomed.sld.cu

Corresponding author.
, Araceli Chico Capote, Rafael Hechavarría, Rosa Jiménez Paneque, Elena Kokuina
Servicio de Reumatología, Hospital Hermanos Ameijeiras, Havana City, Cuba
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Abstract
Objective

To determine damage presence and predictors factors for its appearance in a cohort of Cuban patients with systemic lupus erythematosus (SLE).

Patients and methods

A retrospective cohort study included 80 patients presenting with SLE seen in Rheumatology Service of “Hermanos Ameijeiras” Clinical Surgical Hospital in Havana City, Cuba. Damage was assessed using The Systemic Lupus International Collaborating Clinics/American College of Rheumatology (ACR) Damage Index (SLIC/ACR), a tool approved for damage measurement. Damage presence was related to initial disease features to diagnose this condition, to sociodemographic elements, to treatments used, and to the disease course time. Statistical analysis had two variants: the univariate and multivariate type using Chi2 and statistical significance was established in P<.05.

Results

We found that 39 patients (48.8%) had some degree of damage. More involved domains were the musculoskeletal (18.8%), neuropsychiatric, and skin, 16.3%, pulmonary and ocular, present in 15% of cases. In the multivariate analysis, damage was associated with the use of higher than 30mg/day Prednisone doses for more of 4 weeks (OR=54.68, CI 95%=3.56–97.45, P=.001), presence of leukopenia (RO=18.73, CI 95%=2.74–62.23 m P=.004), and time course of disease (OR=1.02, CI 95%=1.00 2–1.09, P=.006).

Conclusions

Damage was practically present in half of the study patients, the most involved domain was the musculoskeletal, and use of higher than 30mg prednisone doses were the factor most associated with the presence of damage.

Keywords:
Systemic lupus erythematosus
Damage
Damage predictor
Resumen
Objetivo

Determinar la presencia de daño y factores predictores de su aparición en una cohorte de pacientes cubanos con lupus eritematoso sistémico (LES).

Pacientes y método

Se realizó un estudio de cohorte retrospectivo que incluyó a 80 pacientes con LES atendidos en el Servicio de Reumatología del Hospital Hermanos Ameijeiras en la ciudad de La Habana, Cuba. El daño fue determinado aplicando el Systemic Lupus International Collaborating Clinics/American College of Rheumatology (SLICC/ACR) Damage Index. La presencia de daño se relacionó con las características iniciales de la enfermedad al diagnóstico, con elementos sociodemográficos, con los tratamientos utilizados y con el tiempo de evolución de la enfermedad. El análisis estadístico incluyó estudios univariante y multivariado, y se utilizó el test de Chi-cuadrado (la significación estadística se fijó en p=0,05).

Resultados

Encontramos que 39 pacientes (48,8%) tenían algún grado de daño. Los dominios más afectados fueron el músculo esquelético (18,8%), el neuropsiquiátrico y la piel, ambos con un 16,3%. En el análisis multivariado el daño se asoció con la utilización de dosis de prednisona mayores de 30mg diarios por más de cuatro semanas (OR = 54,68; IC 95%: 3,56–97,45; p=0,001), presencia de leucopenia (OR = 18,73; IC 95%: 2,74–62,23; p=0,004) y el tiempo mayor de evolución de la enfermedad (OR = 1,02; IC 95%:1,002–1,09; p=0,006).

Conclusiones

El daño estuvo presente prácticamente en la mitad de los pacientes estudiados, el dominio más afectado fue el musculoesquelético y la utilización de dosis mayores a 30mg de prednisona fue el factor más asociado con la presencia de daño.

Palabras clave:
Lupus eritematoso sistémico
Daño
Predictor de daño
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