The initial predictors of death in 153 patients with ANCA-associated vasculitis in a single Korean centre.

Authors:
Chin Hee Mun
Chin Hee Mun
Yonsei University College of Medicine
Juyoung Yoo
Juyoung Yoo
Yonsei University College of Medicine
South Korea
Seung Min Jung
Seung Min Jung
College of Medicine
Jason Jungsik Song
Jason Jungsik Song
Yonsei University College of Medicine
Yong-Beom Park
Yong-Beom Park
Yonsei University College of Medicine
South Korea
Sang-Won Lee
Sang-Won Lee
South Korea

Clin Exp Rheumatol 2018 Mar-Apr;36 Suppl 111(2):65-72. Epub 2018 Feb 14.

Division of Rheumatology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.

Objectives: We estimated the cumulative patient survival rates, the causes of death and the initial predictors of death in Korean patients with microscopic polyangiitis (MPA), granulomatosis with polyangiitis (GPA) and eosinophilic GPA (EGPA).

Methods: We reviewed the medical records of 153 patients with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV). We collected clinical and laboratory data including ANCA, Birmingham vasculitis activity score (BVAS), five factor score (FFS) (2009), comorbidities, medications and prognosis (death and relapse). The hazard ratio (HR) of variables at diagnosis for death in the disease course was assessed by the Cox hazard model analysis.

Results: The mean age of 153 AAV patients (47 men and 106 women) was 55.2 years and the mean follow-up duration was 51.5 months. Fourteen of 153 patients (9.2%) died (7 MPA and 7 GPA patients) during the mean follow-up of 56.9 months. In all patients with AAV, 1 year-, 5 year- and 10 year-cumulative patient survival rates were 96.1%, 94.8% and 92.8%, respectively. The most common cause of death was infection of various causes. FFS (2009) ≥2 (HR 16.520, p=0.012) and diffuse alveolar haemorrhage (DAH) (HR 3.705, p=0.042) at diagnosis could predict death during the follow-up in AAV patients in multivariate COX regression analysis.

Conclusions: The overall mortality rate was 9.2% and 10-year cumulative patient survival rate was 92.8%. At diagnosis, FFS (2009) ≥ 2 and DAH were independent predictors of death during the follow-up in Korean patients with MPA, GPA and EGPA.
February 2018
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