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系统性硬化症患者的合并症负担与死亡率。

Comorbidity burden on mortality in patients with systemic sclerosis.

机构信息

Médecine Interne, Hopital Saint-Antoine, Paris, France

Pôle Biologie et Pathologie, CHU de Bordeaux, Bordeaux, France.

出版信息

RMD Open. 2024 Oct 18;10(4):e004637. doi: 10.1136/rmdopen-2024-004637.

Abstract

INTRODUCTION

Systemic sclerosis (SSc) is a serious life-threatening tissue disease. A significant aspect of its mortality arises from comorbid conditions. Our study aimed at mapping out the prevalence of these comorbidities and their relation to mortality, thus creating a 'comorbidome'.

METHODS

In our retrospective, single-centre observational study, we recorded each patient's data, including demographic informations, vital stats and SSc-related organ involvement, along with the presence or absence of 14 predefined comorbidities. We also documented the dates of their initial and most recent visits. To construct survival curves, we used the Kaplan-Meier method, followed by a Cox regression model for multivariate analysis.

RESULTS

Our study involved 400 participants, 74 of whom unfortunately passed away. It is important to note that three specific comorbidities showed significant correlation to mortality: neoplasia, cardiovascular diseases and polypharmacy, as well as two SSc-specific organ involvements (lung and cardiac).

CONCLUSION

Our research led to the successful creation of the SSc comorbidome. Comorbidities are a major concern for patients suffering from SSc, particularly cardiovascular diseases and neoplasms. Our study highlights the effects of polypharmacy. The resultant comorbidome offers a comprehensive and analytical perspective on this complex issue and underscores the inter-relatedness of the data. Our study, however, was limited by a small sample size. Therefore, to confirm our findings, validation on a larger scale is necessary. This could potentially contribute to the creation of a future mortality scoring tool.

摘要

简介

系统性硬化症(SSc)是一种严重的危及生命的组织疾病。其死亡率的一个重要方面源于合并症。我们的研究旨在绘制这些合并症的患病率及其与死亡率的关系,从而创建一个“合并症图谱”。

方法

在我们的回顾性、单中心观察性研究中,我们记录了每位患者的数据,包括人口统计学信息、生命统计数据和 SSc 相关器官受累情况,以及 14 种预先定义的合并症的存在或缺失情况。我们还记录了他们首次和最近就诊的日期。为了构建生存曲线,我们使用了 Kaplan-Meier 方法,然后进行了 Cox 回归模型的多变量分析。

结果

我们的研究涉及 400 名参与者,其中不幸去世的有 74 人。值得注意的是,有三种特定的合并症与死亡率显著相关:肿瘤、心血管疾病和多药治疗,以及两种 SSc 特异性器官受累(肺部和心脏)。

结论

我们的研究成功创建了 SSc 合并症图谱。合并症是 SSc 患者的主要关注点,特别是心血管疾病和肿瘤。我们的研究强调了多药治疗的影响。由此产生的合并症图谱提供了一个全面和分析性的视角来看待这个复杂的问题,并强调了数据的相互关联性。然而,我们的研究受到样本量小的限制。因此,为了确认我们的发现,需要在更大规模上进行验证。这可能有助于创建未来的死亡率评分工具。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/45ae/11492939/7bbc179cbe05/rmdopen-10-4-g001.jpg

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