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Abstract
Objectives To investigate the mortality and the causes of death in Chinese patients with dermatomyositis (DM) or polymyositis (PM).
Methods We collected the clinical data of all DM/PM patients in Rheumatology department of Peking University First Hospital from January 2007 to May 2016.The primary causes of death were identified, the standardised mortality ratio (SMR) and years of life lost (YLL) were calculated based on the National Bureau of Statistics of China for the general population, the survival in the first decade was performed using Kaplan-Meier analysis, and the predictors of mortality were evaluated by multivariable cox regression.
Results A total of 226 DM and 54 PM cases were included and the mean age of onset was 49.9±14.8 years for DM and 48.1±17.1 years for PM. The median follow-up duration was 40.6 (11.6–77.6) months. Among 267 patients who were successfully traced, 66 patients died. Infection (50.0%) was the leading cause of death followed by malignancy (19.7%), and interstitial lung disease (ILD) (9.1%). The overall age and sex adjusted SMR was 9.0 (95% CI 6.8–11.2) for DM, and 5.0 (95% CI 2.4–7.5) for PM. The overall age and sex adjusted SMR of DM/PM patients with ILD was 8.4 (95% CI 5.8–11.0), and the SMR of the patients with malignancy was 14.9 (95% CI 8.5–21.2). The YLL of women and men were 37.5 and 28.4 years respectively for DM, and 24.3 and 12.0 years respectively for PM (Table1). The 10-year survival of patients with ILD or malignancy was significantly worse than those without ILD or malignancy respectively (Figure 1 and 2). The independent predictors of mortality for DM were age of disease onset, respiratory muscle involvement and malignancy; and the independent predictor of mortality for PM was age at disease onset (Table2).
The standardized mortality ratio (SMR), life expectancy (LE) and years of life lost (YLL)
Multivariable cox regression analyses of risk factors in the DM/PM patients
Conclusions Mortality of DM/PM patients in China is substantial, especially in females, and those with ILD or malignancy. Infection was the leading cause of death. Patients with older age at onset, respiratory muscle involvement, ILD, and malignancy need to be paid more attention.
Disclosure of Interest None declared