Early Mortality in a Multinational Systemic Sclerosis Inception Cohort
| Autor: | Yanjie, Hao, Marie, Hudson, Murray, Baron, Patricia, Carreira, Wendy, Stevens, Candice, Rabusa, Solene, Tatibouet, Loreto, Carmona, Beatriz E, Joven, Molla, Huq, Susanna, Proudman, Mandana, Nikpour, J, Zochling |
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| Rok vydání: | 2016 |
| Předmět: |
0301 basic medicine
Adult Male medicine.medical_specialty Canada Heart Diseases Hypertension Pulmonary Immunology Myocardial Ischemia Disease Kaplan-Meier Estimate Cohort Studies 03 medical and health sciences 0302 clinical medicine Rheumatology Internal medicine Cause of Death Neoplasms Sepsis medicine Immunology and Allergy Humans Mortality Case report form Cause of death Aged Autoantibodies 030203 arthritis & rheumatology Scleroderma Systemic Proportional hazards model business.industry Australia Middle Aged Prognosis 3. Good health Surgery Cerebrovascular Disorders Intestinal Diseases 030104 developmental biology Standardized mortality ratio Years of potential life lost Spain Cohort Female Kidney Diseases business Lung Diseases Interstitial Cohort study |
| Zdroj: | Arthritisrheumatology (Hoboken, N.J.). 69(5) |
| ISSN: | 2326-5205 |
| Popis: | Objective: To determine mortality and causes of death in a multinational inception systemic sclerosis (SSc) cohort. Methods: We quantified mortality as Standardized Mortality Ratio (SMR), Years of Life Lost (YLL) and percentage mortality in the first decade of disease. The inception cohort was comprised of patients recruited within 4 years of disease onset. For comparison, we used a prevalent cohort, which included all patients irrespective of disease duration at recruitment. We determined a single primary cause of death (SSc or non-SSc related) using a standardized case report form, and evaluated predictors of mortality using multivariable Cox regression. Results: In the inception cohort of 1070 patients, there were 140 (13%) deaths over a median (IQR) follow-up of 3.0(1.0-5.1) years, with a pooled SMR of 4.06 (95% CI 3.39–4.85), up to 22.4 YLL in women and 26.0 YLL in men, and mortality in the diffuse disease subtype of 24.2% at 8 years. In the prevalent cohort of 3218 patients, the pooled SMR was lower at 3.39 (95% CI 3.06-3.71), and percentage mortality in diffuse disease was lower (9.3% at 8 years). In the inception cohort, 62.1% of the primary causes of death were SSc related. Malignancy, sepsis, ischemic heart disease and cerebrovascular disease were the most common non-SSc related causes. Predictors of early mortality included male, diffuse disease, pulmonary arterial hypertension and renal crisis. Conclusion: Early mortality in SSc is substantial and prevalent cohorts underestimate mortality in SSc by failing to capture early deaths, particularly in men and those with diffuse disease. This article is protected by copyright. All rights reserved. |
| Databáze: | OpenAIRE |
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