Causes and risk factors for death in systemic sclerosis: a study from the EULAR Scleroderma Trials and Research (EUSTAR) database
| Autor: | Tyndall, A. J., Bannert, B., Vonk, M., Airo, P., Cozzi, F., Carreira, P. E., Bancel, D. F., Allanore, Y., Muller Ladner, U., Distler, O., Iannone, F., Pellerito, R., Pileckyte, M., Miniati, I., Ananieva, L., Gurman, A. B., Damjanov, N., Mueller, A., Valentini, G., Riemekasten, G., Tikly, M., Hummers, L., Henriques, M. J. S., Caramaschi, P., Scheja, A., Rozman, B., Ton, E., Kumanovics, G., Coleiro, B., Feierl, E., Szucs, G., Von Muhlen, C. A., Riccieri, Valeria, Novak, S., Chizzolini, C., Kotulska, A., Denton, C., Coelho, P. C., Kotter, I., Simsek, I., La Pena, D. E., Lefebvre, P. G. D. L. P., Hachulla, E., Seibold, J. R., Rednic, S., Stork, J., Morovic Vergles, J., Walker, U. A. |
|---|---|
| Přispěvatelé: | Tyndall, Aj, Bannert, B, Vonk, M, Airò, P, Cozzi, F, Carreira, Pe, Bancel, Df, Allanore, Y, MÜLLER LADNER, U, Distler, O, Iannone, F, Pellerito, R, Pileckyte, M, Miniati, I, Ananieva, L, Gurman, Ab, Damjanov, N, Mueller, A, Valentini, Gabriele, Riemekasten, G, Tikly, M, Hummers, L, Henriques, Mj, Caramaschi, P, Scheja, A, Rozman, B, Ton, E, Kumánovics, G, Coleiro, B, Feierl, E, Szucs, G, VON MÜHLEN, Ca, Riccieri, V, Novak, S, Chizzolini, C, Kotulska, A, Denton, C, Coelho, Pc, Kötter, I, Simsek, I, DE LA PENA LEFEBVRE, Pg, Hachulla, E, Seibold, Jr, Rednic, S, Stork, J, MOROVIC VERGLES, J, Walker, Ua |
| Rok vydání: | 2010 |
| Předmět: |
Lung Diseases
systemic sclreosis risk factors Male Lung Diseases/mortality Comorbidity 030204 cardiovascular system & hematology 0302 clinical medicine Neoplasms Epidemiology Pulmonary fibrosis Immunology and Allergy skin and connective tissue diseases Cause of death ddc:616 integumentary system Interstitial lung disease Sepsis/mortality Middle Aged Prognosis 3. Good health Pneumonia/mortality Cohort Female Neoplasms/mortality Gastrointestinal Hemorrhage Scleroderma Systemic/*mortality Adult medicine.medical_specialty Heart Diseases Immunology Auto-immunity transplantation and immunotherapy [N4i 4] General Biochemistry Genetics and Molecular Biology 03 medical and health sciences Rheumatology Sepsis Internal medicine medicine Humans Gastrointestinal Hemorrhage/mortality Risk factor Health care ethics [NCEBP 5] Aged 030203 arthritis & rheumatology Scleroderma Systemic business.industry Proportional hazards model Heart Diseases/mortality Pneumonia medicine.disease Surgery Evaluation of complex medical interventions [NCEBP 2] Heart failure business Epidemiologic Methods |
| Zdroj: | Annals of the Rheumatic Diseases, 69, 10, pp. 1809-15 Annals of the rheumatic diseases Annals of the Rheumatic Diseases, Vol. 69, No 10 (2010) pp. 1809-1815 Annals of the Rheumatic Diseases, 69, 1809-15 |
| ISSN: | 0003-4967 |
| DOI: | 10.1136/ard.2009.114264 |
| Popis: | Item does not contain fulltext OBJECTIVES: To determine the causes and predictors of mortality in systemic sclerosis (SSc). METHODS: Patients with SSc (n=5860) fulfilling the American College of Rheumatology criteria and prospectively followed in the EULAR Scleroderma Trials and Research (EUSTAR) cohort were analysed. EUSTAR centres completed a structured questionnaire on cause of death and comorbidities. Kaplan-Meier and Cox proportional hazards models were used to analyse survival in SSc subgroups and to identify predictors of mortality. RESULTS: Questionnaires were obtained on 234 of 284 fatalities. 55% of deaths were attributed directly to SSc and 41% to non-SSc causes; in 4% the cause of death was not assigned. Of the SSc-related deaths, 35% were attributed to pulmonary fibrosis, 26% to pulmonary arterial hypertension (PAH) and 26% to cardiac causes (mainly heart failure and arrhythmias). Among the non-SSc-related causes, infections (33%) and malignancies (31%) were followed by cardiovascular causes (29%). Of the non-SSc-related fatalities, 25% died of causes in which SSc-related complications may have participated (pneumonia, sepsis and gastrointestinal haemorrhage). Independent risk factors for mortality and their HR were: proteinuria (HR 3.34), the presence of PAH based on echocardiography (HR 2.02), pulmonary restriction (forced vital capacity below 80% of normal, HR 1.64), dyspnoea above New York Heart Association class II (HR 1.61), diffusing capacity of the lung (HR 1.20 per 10% decrease), patient age at onset of Raynaud's phenomenon (HR 1.30 per 10 years) and the modified Rodnan skin score (HR 1.20 per 10 score points). CONCLUSION: Disease-related causes, in particular pulmonary fibrosis, PAH and cardiac causes, accounted for the majority of deaths in SSc. 01 oktober 2010 |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|