Comorbidity burden on mortality in patients with systemic sclerosis

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.

Keywords: Connective Tissue Diseases; Mortality; Scleroderma, Systemic.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Aged
  • Cardiovascular Diseases / epidemiology
  • Cardiovascular Diseases / mortality
  • Comorbidity*
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Neoplasms / complications
  • Neoplasms / epidemiology
  • Neoplasms / mortality
  • Prevalence
  • Proportional Hazards Models
  • Retrospective Studies
  • Scleroderma, Systemic* / complications
  • Scleroderma, Systemic* / epidemiology
  • Scleroderma, Systemic* / mortality