Incidence and risk factors for gangrene in patients with systemic sclerosis from the EUSTAR cohort.
Détails
ID Serval
serval:BIB_07BEDE96F20E
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Incidence and risk factors for gangrene in patients with systemic sclerosis from the EUSTAR cohort.
Périodique
Rheumatology
Collaborateur⸱rice⸱s
EUSTAR collaborators
Contributeur⸱rice⸱s
Lepri G., Jaeger V.K., Walker U.A., Iannone F., Cacciapaglia F., Tomčík M., Becvar R., Rednic S., Petcu A., Szabo I., Codullo V., Caporali R., Montecucco C., Carreira P., Ioven B., Minier T., Czirják L., Chizzolini C., Allali D., Zanatta E., Doria A., Gabrielli A., Airò P., Lazzaroni M.G., Radić M., Martinovic D., Braun-Moscovici Y., Balbir-Gurman A., Hunzelmann N., Caramaschi P., Morovic-Vergles J., Denton C., Santamaria V.O., Heitmann S., Krasowska D., Michalska-Jakubus M., Seidel M., Foeldvari I., Helmus N., Salvador M.J., Stamenkovic B., Stankovic A., Ananieva L., Herrick A., Engelhart M., De La Puente C., Hoffmann-Vold A.M., Midtvedt Ø., Launay D., Sobanski V., Riccieri V., Opris-Belinski D., Groseanu L., Ionescu R.M., Bojinca M., Sunderkötter C., Distler J., Ingegnoli F., van der Haecke A., Ullman S., Pozzi M.R., Eyerich K., Vanthuyne M., Erler A., Aringer M., De Langhe E., Baresic M., Mayer M., Anic B., Yavuz S., Granel B., Popa S., Agachi S., Zenone T., Mathieu A., Vacca A., Solanki K., Veale D., Loyo E., Tineo C., Gigante A., Rosato E., Oksel F., Yagurcu F., Tănăseanu C.M., Visalli E., Benenati A., Foti R., Ancuta C., Dan D., Adler S., Villiger P., Fathi N., de la Peña Lefebvre P.G., Martín JJG, Chatelus E., Sibilia J., Litinsky I., Del Galdo F., Sakettkoo L.A., Kerzberg E., Bianchi W.A., Bianchi B.V., Castellví I., Limonta M., Rimar D., Couto M., Ribi C., Spertini F., Kahl S., Hsu V., Poindron V., Meghit K., Martin T., Kolstad K., Chung L., Thiele A., Schmeiser T., Zdrojewski Z., Riemekasten G., Levy Y., Cardoneanu A., Burlui A., Rezus E., Pamuk O.N., Talotta R., Bongiovanni S., Puttini P.S.
ISSN
1462-0332 (Electronic)
ISSN-L
1462-0324
Statut éditorial
Publié
Date de publication
01/08/2020
Peer-reviewed
Oui
Volume
59
Numéro
8
Pages
2016-2023
Langue
anglais
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Publication Status: ppublish
Résumé
In patients with SSc, peripheral vasculopathy can promote critical ischaemia and gangrene. The aim of this study was to investigate the prevalence, incidence and risk factors for gangrene in the EUSTAR cohort.
We included patients from the EUSTAR database fulfilling the ACR 1980 or the ACR/EULAR 2013 classification criteria for SSc, with at least one visit recording data on gangrene. Centres were asked for supplementary data on traditional cardiovascular risk factors. We analysed the cross-sectional relationship between gangrene and its potential risk factors by univariable and multivariable logistic regression. Longitudinal data were analysed by Cox proportional hazards regression.
1757 patients were analysed (age 55.9 [14.5] years, disease duration 7.9 [10.3] years, male sex 16.7%, 24.6% diffuse cutaneous subset [dcSSc]). At inclusion, 8.9% of patients had current or previous digital gangrene, 16.1% had current digital ulcers (DUs) and 42.7% had ever had DUs (current or previous). Older age, DUs ever and dcSSc were statistically significant risk factors for gangrene in the cross-sectional multivariable model. During a median follow-up of 13.1 months, 16/771 (0.9%) patients developed gangrene. All 16 patients who developed gangrene had previously had DUs and gangrene. Further risk factors for incident gangrene were the dcSSc subset and longer disease duration.
In unselected SSc patients, gangrene occurs in about 9% of SSc patients. DUs ever and, to a lesser extent, the dcSSc subset are strongly and independently associated with gangrene, while traditional cardiovascular risk factors could not be identified as risk factors.
We included patients from the EUSTAR database fulfilling the ACR 1980 or the ACR/EULAR 2013 classification criteria for SSc, with at least one visit recording data on gangrene. Centres were asked for supplementary data on traditional cardiovascular risk factors. We analysed the cross-sectional relationship between gangrene and its potential risk factors by univariable and multivariable logistic regression. Longitudinal data were analysed by Cox proportional hazards regression.
1757 patients were analysed (age 55.9 [14.5] years, disease duration 7.9 [10.3] years, male sex 16.7%, 24.6% diffuse cutaneous subset [dcSSc]). At inclusion, 8.9% of patients had current or previous digital gangrene, 16.1% had current digital ulcers (DUs) and 42.7% had ever had DUs (current or previous). Older age, DUs ever and dcSSc were statistically significant risk factors for gangrene in the cross-sectional multivariable model. During a median follow-up of 13.1 months, 16/771 (0.9%) patients developed gangrene. All 16 patients who developed gangrene had previously had DUs and gangrene. Further risk factors for incident gangrene were the dcSSc subset and longer disease duration.
In unselected SSc patients, gangrene occurs in about 9% of SSc patients. DUs ever and, to a lesser extent, the dcSSc subset are strongly and independently associated with gangrene, while traditional cardiovascular risk factors could not be identified as risk factors.
Mots-clé
Adult, Aged, Cohort Studies, Cross-Sectional Studies, Databases, Factual, Female, Gangrene/epidemiology, Gangrene/etiology, Humans, Incidence, Male, Middle Aged, Risk Factors, Scleroderma, Systemic/complications, digital ulcers, gangrene, systemic sclerosis, vasculopathy
Pubmed
Web of science
Création de la notice
02/08/2021 15:43
Dernière modification de la notice
31/05/2024 6:12
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