Evaluation of damage from disease in patients with systemic lupus erythematosus according to the systemic lupus international collaborating clinics / American college of rheumatology damage index (SLICC / ACR DI) in a tertiary care hospital in Sri Lanka

Abstract

Systemic Lupus Erythematosus (SLE) is a chronic inflammatory autoimmune disease that affects multiple organ systems and can lead to irreversible damage from the disease itself, its treatments, or associated comorbidities. Prior studies suggest that SLE manifests more severely in Asian populations, including Sri Lankans. This study aimed to assess the extent and severity of organ damage in a defined population of Sri Lankan patients with SLE, identify baseline patient characteristics, and determine the specific domains of damage using the validated SLICC/ACR Damage Index. A cross-sectional descriptive quantitative study was conducted from September 18 to November 13, 2023, involving 67 patients attending the Rheumatology Clinic at Teaching Hospital Peradeniya. Data were collected through patient interviews and reviews of clinical records. The extent of damage was analyzed using frequency and percentages, while associations between variables and accrued damage were evaluated via Spearman correlation and the Mann-Whitney U test. Of the 67 patients, 94% were female, and the mean age was 35.3 years. Most participants were Sinhalese (82.1%). The mean disease duration was 7.35 ± 7.476 years, and the mean age at diagnosis was approximately 27.97 ± 13.548 years. Nearly half the study (47.7%) exhibited some degree of damage, with the peripheral vascular system being the most commonly affected (41.8%). The greatest prevalence of damage was found in the 20–39 age group. Female patients showed a higher average damage score (1.27 ± 1.798) compared to males (1.0 ± 2.0). In conclusion, while SLE-related damage was present in less than half the study population, it remains more common among females, with the peripheral vascular system being the most frequently affected. No statistically significant factors were found to influence the extent of disease damage in this study.