UNIGE document Scientific Article
previous document  unige:21355  next document
add to browser collection

Causes and risk factors for death in systemic sclerosis: a study from the EULAR Scleroderma Trials and Research (EUSTAR) database

Tyndall, Anthony J.
Bannert, Bettina
Vonk, Madelon
Airo, Paolo
Cozzi, Franco
Carreira, Patricia E.
Bancel, Dominique Farge
Allanore, Yannick
show hidden authors show all authors [1 - 47]
Published in Annals of the Rheumatic Diseases. 2010, vol. 69, no. 10, p. 1809-1815
Abstract 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.
Keywords AdultAgedComorbidityEpidemiologic MethodsFemaleGastrointestinal Hemorrhage/mortalityHeart Diseases/mortalityHumansLung Diseases/mortalityMaleMiddle AgedNeoplasms/mortalityPneumonia/mortalityPrognosisScleroderma, Systemic/*mortalitySepsis/mortality
PMID: 20551155
Full text
Article - document accessible for UNIGE members only Limited access to UNIGE
Other version: http://ard.bmj.com/content/69/10/1809.full.pdf
Research group La matrice extracellulaire (651)
(ISO format)
TYNDALL, Anthony J. et al. Causes and risk factors for death in systemic sclerosis: a study from the EULAR Scleroderma Trials and Research (EUSTAR) database. In: Annals of the Rheumatic Diseases, 2010, vol. 69, n° 10, p. 1809-1815. https://archive-ouverte.unige.ch/unige:21355

198 hits

0 download


Deposited on : 2012-05-23

Export document
Format :
Citation style :