Clinical aspects
The presence of small joint contractures is a risk factor for survival in 439 patients with systemic sclerosis.
G. Nagy1, T. Minier2, C. Varjú3, R. Faludi4, K.T. Kovács5, V. Lóránd6, V. Hermann7, L. Czirják8, G. Kumánovics9
- Department of Rheumatology and Immunology, University of Pécs, Hungary. nagy.gabriella@pte.hu
- Department of Rheumatology and Immunology, University of Pécs, Hungary.
- Department of Rheumatology and Immunology, University of Pécs, Hungary.
- Heart Institute, Medical Center University of Pécs, Hungary.
- Department of Rheumatology and Immunology, University of Pécs, Hungary.
- Department of Rheumatology, Polyclinic of the Hospitaller Brothers of St. John of God, Budapest, Hungary.
- Department of Rheumatology and Immunology, University of Pécs, Hungary.
- Department of Rheumatology and Immunology, University of Pécs, Hungary.
- Department of Rheumatology and Immunology, University of Pécs, Hungary.
CER10142
2017 Vol.35, N°4 ,Suppl.106
PI 0061, PF 0070
Clinical aspects
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PMID: 28869411 [PubMed]
Received: 04/12/2016
Accepted : 06/03/2017
In Press: 31/08/2017
Published: 12/10/2017
Abstract
OBJECTIVES:
Analysis of risk factors and mortality of 439 patients with systemic sclerosis (SSc) in a tertiary care centre.
METHODS:
The mean follow up time was 8.4±5.6 years. Lost to follow up rate was 6.4%. Female to male ratio was 366 to 73. Two hundred sixty patients had limited and 179 diffuse cutaneous SSc (dcSSc). A standard protocol including musculoskeletal examinations was used for the assessment of patients.
RESULTS:
By Kaplan-Meier analysis the overall 5-, 10- and 15 year survival were 88.2%, 79.9% and 73.6%, respectively. Univariate analysis showed that dcSSc, male gender, presence of small joint contractures, pulmonary interstitial, cardiac, oesophageal involvement, scleroderma renal crisis, arterial hypertension, anti-topoisomerase antibody, anemia, hypalbuminemia, coexistent malignancies and elevated erythrocyte sedimentation were associated with poor survival. Lack of giant capillaries, avascular zones or neo-angiogenesis on capillaroscopy, and presence of anti-centromere antibodies were associated with favourable outcome. Multivariate regression analysis showed presence of small joint contractures, history of arterial hypertension, male gender, diffusing capacity of carbon monoxide <50%, right ventricular pressure >40 mmHg on echocardiography, less than 50% ejection fraction, anti-topoisomerase I positivity, anemia, and serum albumin concentration < 35 g/l as well as current or history of coexistent malignancy were independent poor prognostic factors. Conclusions. In addition to well-known factors predicting poor outcome in SSc, the presence of small joint contractures was a newly identi ed independent risk factor of mortality. Our data also confirmed a recent finding showing that history of arterial hypertension was also a poor prognostic factor.
