Lupus ups risk of spontaneous subarachnoid hemorrhage

April 19, 2013
Lupus ups risk of spontaneous subarachnoid hemorrhage
Patients with systemic lupus erythematosus have an increased risk of spontaneous subarachnoid hemorrhage (SAH) and increased mortality after SAH, according to a study published in the April issue of Arthritis Care & Research.

(HealthDay)—Patients with systemic lupus erythematosus (SLE) have an increased risk of spontaneous subarachnoid hemorrhage (SAH) and increased mortality after SAH, according to a study published in the April issue of Arthritis Care & Research.

Yu-Sheng Chang, M.D., from Shuang Ho Hospital in Taipei, Taiwan, and colleagues conducted a nationwide, population-based study to assess the risk of SAH among patients with SLE. The incidence of SAH was compared in a cohort of 16,967 patients with SLE identified from the Taiwan National Health Insurance (NHI) database and 16,967 randomly selected age- and sex-matched individuals without SLE.

The researchers found that the incidence of SAH was significantly higher in the SLE cohort (incidence rate ratio, 4.84). Compared with all the non-SLE SAH patients identified from the NHI database, the mortality rate after SAH was significantly higher for patients with SLE, despite a younger age (60 versus 38.9 percent). Independent risk factors for new-onset SAH included age (hazard ratio [HR], 1.03); platelet transfusion (HR, 2.75); red blood cell transfusion (HR, 7.11); and a mean daily steroid dose greater than 10 mg prednisolone or equivalent (HR, 4.36).

"In conclusion, our study is the first to demonstrate a higher risk of SAH in SLE patients using a nationwide population data set," the authors write. "Elderly SLE patients and those with a higher mean daily steroid dose and a history of platelet or red blood cell transfusion had a higher risk of developing SAH."

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