Brief Report: Lupus-An Unrecognized Leading Cause of Death in Young Females: A Population-Based Study Using Nationwide Death Certificates, 2000-2015

Abstract

Objective: Mortality statistics from the Centers for Disease Control and Prevention (CDC) are used for planning health care policy and allocating resources. The CDC uses these data to compile its annual ranking of leading causes of death based on a selected list of 113 causes. Systemic lupus erythematosus (SLE) is not included on this list. Since the ranking is a useful tool for assessing the relative burden of cause-specific mortality, this study was undertaken to rank SLE deaths among the CDC's leading causes of death to see whether SLE is a significant cause of death among females.

Methods: Death counts for the female population of the US were obtained from the CDC's Wide-ranging Online Data for Epidemiologic Research database and then grouped by age and race/ethnicity. Data on the leading causes of death were obtained from the Web-based Injury Statistics Query and Reporting System database.

Results: During 2000-2015, there were 28,411 deaths of females with SLE recorded as an underlying or contributing cause of death. SLE ranked among the top 20 leading causes of death in females between 5 and 64 years of age. SLE ranked tenth among those ages 15-24 years, fourteenth among those ages 25-34 years and 35-44 years, and fifteenth among those ages 10-14 years. For African American and Hispanic females, SLE ranked fifth among those ages 15-24 years, sixth among those ages 25-34 years, and eighth or ninth among those ages 35-44 years, after the 3 common external injury causes of death were excluded from the analysis.

Conclusion: SLE is among the leading causes of death in young females, underscoring its impact as an important public health issue.

Figure 1. Leading Causes of Deaths for Females of Reproductive Age by Race/Ethnicity and Age

The ranking of SLE relative to the official 10 leading causes of death in women of reproductive age in the United States from 2000–2015 is displayed. SLE deaths include cases where SLE was listed as the underlying or contributing cause of death using ICD-10 code M32 (all deaths since 1999 have been coded using ICD-10). To focus on the organic causes of death, we excluded the external injury causes of death, namely unintentional injury, homicide, and suicide, from this analysis. Ranking is shown for women of all races (left panels), non-Hispanic Black (middle), and Hispanic women (right) in 15–24-year (top), 25–34-year (middle), and 35–44-year (bottom) age groups. ICD, International Classification of Diseases.