Department of Rheumatology, Pellegrin Hospital, University Hospital of Bordeaux, Bordeaux, France.
Department of Dermatology and Paediatric Dermatology, National Reference Center for Rare Skin Diseases, Saint-André Hospital, University Hospital of Bordeaux, Bordeaux, France.
J Eur Acad Dermatol Venereol. 2019 Feb;33(2):405-409. doi: 10.1111/jdv.15114. Epub 2018 Jul 17.
Survival can be threatened in certain forms of systemic sclerosis (SSc) so clear prognostic factors are needed.
The aim of this meta-analysis was to assess the association between the presence of digital ulcers (DUs) and mortality in SSc.
We performed a systematic review and meta-analysis in the Pubmed and Scopus databases from the earliest records to May 2017. Two research strategies were performed: « systemic sclerosis » and « digital ulcers » (strategy A); « systemic sclerosis » and « mortality » (strategy B). The primary outcome was the mortality associated with the presence of DUs in patients with SSc.
The literature search identified 1473 citations. Fifty-nine studies were examined for full text. Ten articles were included for the meta-analysis. SSc patients with DUs had an increased pooled mortality risk: RR = 1.53 (IC 95%: [1.23-1.90]).
This meta-analysis revealed a higher mortality in SSc patients with associated DUs. Having DUs may be a predictive factor of developing organ involvement such as pulmonary or cardiovascular events that could be associated with poor survival. It suggests that early screening of DUs in SSc patients is important to identify patients most at risk of poor survival.
某些类型的系统性硬化症（SSc）可威胁患者的生存，因此需要明确的预后因素。
本荟萃分析旨在评估指溃疡（DU）与 SSc 患者死亡率之间的关系。
我们在 Pubmed 和 Scopus 数据库中进行了系统评价和荟萃分析，检索时间从最早记录到 2017 年 5 月。采用了两种研究策略：“系统性硬化症”和“指溃疡”（策略 A）；“系统性硬化症”和“死亡率”（策略 B）。主要结局是 SSc 患者存在 DU 与其死亡率之间的相关性。
文献检索共确定了 1473 条引文。对 59 项研究进行了全文检查。有 10 篇文章被纳入荟萃分析。患有 DU 的 SSc 患者的死亡率风险增加：RR = 1.53（95%CI：[1.23-1.90]）。
本荟萃分析表明，存在 DU 的 SSc 患者死亡率更高。存在 DU 可能是发生肺或心血管等器官受累的预测因素，而这些器官受累可能与生存不良相关。这提示我们对 SSc 患者进行 DU 的早期筛查很重要，以识别生存不良风险最高的患者。
