Clinical outcomes and associated factors with mortality in systemic sclerosis patients with sarcopenia.

Sirada Hongkanjanapong, Patnarin Pongkulkiat, Ajanee Mahakkanukrauh, Siraphop Suwannaroj, Chingching Foocharoen
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Abstract

Background: Despite the high incidence of sarcopenia in systemic sclerosis (SSc) patients, there is currently limited evidence on their outcomes.

Objectives: Our study aimed to determine clinical courses, outcomes, and identify factors associated with mortality in the SSc patients with sarcopenia.

Methods: A historical cohort study was conducted in 180 adult SSc patients diagnosed with sarcopenia according to the criteria of Asian Working Group for Sarcopenia 2019, who were attending the Scleroderma Clinic at Khon Kaen University between July 2019 and November 2021.

Results: Forty-one were diagnosed with sarcopenia. A total of 443.8 persons-year, the respective mortality rate for SSc patients with and without sarcopenia was 5.05 and 5.22 per 100-person-years, showing no statistical difference (p = 0.58). Sarcopenia was not a significant mortality risk in SSc patients with a hazard ratio (HR) of 1.34, 95 % CI 0.48-3.75. The survival rate from the baseline evaluation of sarcopenia to the last follow-up of the patients with sarcopenia at 6-, 12-, 18-, and 24-months were 97.6 %, 95.1 %, 92.7 %, and 87.8 %. Hospitalization was the sole factor significantly associated with the mortality risk, with a HR of 14.21 (95 % CI 2.36-85.60). Sarcopenia itself did not appear to be a significant predictor of disease progression, it did contribute significantly to the progression of salt and pepper skin (p=0.01).

Conclusions: The mortality rate of SSc patients with sarcopenia increased after a 2-year follow-up but no difference from non-sarcopenic patients. Once these patients required hospitalization, the mortality risk increased by over 10 times. Further long-term follow-up in a large cohort is suggested.

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患有肌肉疏松症的系统性硬化症患者的临床疗效及相关死亡因素。
背景:尽管系统性硬化症(SSc)患者中肌肉疏松症的发病率很高,但目前有关其预后的证据却很有限:我们的研究旨在确定患有肌肉疏松症的 SSc 患者的临床病程、预后,并找出与死亡率相关的因素:方法:根据 2019 年亚洲肌肉疏松症工作组的标准,对 2019 年 7 月至 2021 年 11 月期间在孔敬大学硬皮病诊所就诊的 180 名被诊断为肌肉疏松症的成年 SSc 患者进行了历史队列研究:结果:41人被诊断为肌肉疏松症。有肌少症和无肌少症的 SSc 患者的死亡率分别为每 100 人年 5.05 例和 5.22 例,共计 443.8 人年,无统计学差异(P=0.58)。肌肉疏松症对 SSc 患者的死亡率影响不大,其危险比(HR)为 1.34;95%CI 为 0.48-3.75)。肌肉疏松症患者从基线评估到最后一次随访(6 个月、12 个月、18 个月和 24 个月)的存活率分别为 97.6%、95.1%、92.7% 和 87.8%。住院是唯一与死亡风险明显相关的因素,死亡率为14.21(95%CI2.36-85.60)。肌肉疏松症本身似乎并不是疾病进展的重要预测因素,但它确实对盐和胡椒皮肤的进展有显著影响(P=0.01):结论:随访两年后,患有肌肉疏松症的 SSc 患者的死亡率有所上升,但与非肌肉疏松症患者没有区别。一旦这些患者需要住院治疗,死亡风险将增加 10 倍以上。建议进一步进行大规模的长期随访。
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