RT Journal Article
SR Electronic
T1 Survival and causes of death in 366 Hungarian patients with systemic sclerosis
JF Annals of the Rheumatic Diseases
JO Ann Rheum Dis
FD BMJ Publishing Group Ltd and European League Against Rheumatism
SP 59
OP 63
DO 10.1136/ard.2006.066340
VO 67
IS 1
A1 L Czirják
A1 G Kumánovics
A1 C Varjú
A1 Z Nagy
A1 A Pákozdi
A1 Z Szekanecz
A1 G Szűcs
YR 2008
UL http://ard.bmj.com/content/67/1/59.abstract
AB Objective: Survival analysis of a series of 366 consecutive patients with systemic sclerosis (SSc). Methods: Clinical and laboratory data were evaluated from 1983 until 2005 using a standard protocol. The female/male ratio was 315/51. The mean (SD) age of the patients was 56.8 (12.2) years. The duration of disease was 12 (5–19) years with a median follow-up of 6 (3–12) years. Results: Kaplan–Meier univariate analysis showed that renal, cardiac involvement, pigmentation disturbances, malabsorption, a forced vital capacity <50%, diffuse scleroderma, presence of early malignancy, anaemia, and increased erythrocyte sedimentation rate (ESR) were signs of unfavourable prognosis, whereas anti-centromere antibodies were indicators of a good survival. In the multivariate Cox proportional hazards model the presence of diffuse scleroderma, renal involvement, coexistence of a malignant disease, and increased ESR were poor independent prognostic signs. Elderly age at the onset of disease also caused an unfavourable outcome. A total of 86 SSc-related deaths were recorded during the follow-up. Of them, 65% were attributed to cardiorespiratory manifestation of disease. Tumour associated early death was found in 12 cases (14%). Conclusions: In addition to the well-known factors influencing the outcome (diffuse subset, internal organ involvements, and inflammatory signs), the coexistence of scleroderma with a malignancy also causes a poor outcome.