类风湿性关节炎相关间质性肺病患者的死亡风险因素:一项单中心前瞻性队列研究

IF 4.9 2区 医学 Q1 Medicine Arthritis Research & Therapy Pub Date : 2024-07-19 DOI:10.1186/s13075-024-03362-1
Yeo-Jin Song, Hyoungyoung Kim, Soo-Kyung Cho, Hye Won Kim, Chaewhi Lim, Eunwoo Nam, Chan-Bum Choi, Tae-Hwan Kim, Jae-Bum Jun, Sang-Cheol Bae, Dae Hyun Yoo, Su Jin Hong, Seung-Jin Yoo, Youkyung Lee, Yoon-Kyoung Sung
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引用次数: 0

摘要

目的:与患有类风湿性关节炎(RA)但无间质性肺病(RA-nonILD)的患者相比,确定韩国类风湿性关节炎(RA)相关间质性肺病(ILD)患者的死亡风险因素。数据摘自韩国一家学术转诊医院对接受过胸部计算机断层扫描的 RA 患者进行的单中心前瞻性队列研究。研究选取了2017年5月至2022年8月期间登记的RA-ILD患者,并选取了无ILD的患者作为比较对象。我们计算了死亡率,并调查了每例死亡的原因。我们使用Cox比例危险回归法和Firth惩罚似然法确定RA-ILD患者的死亡风险因素。共纳入了 615 名 RA 患者:其中200例患有ILD,415例未患有ILD。在RA-ILD组中,540.1人年中有15人死亡,死亡率为2.78/100人年。RA-非ILD组在1669.9人年中没有死亡报告。死亡的主要原因是感染(9 例)和肺癌(5 例),只有 1 例死亡归因于 ILD 恶化。高RA活性(调整后HR为1.87,CI为1.16-3.10)、基线一氧化碳弥散能力(DLCO)<60%(调整后HR为4.88,95% CI为1.11-45.94)和常见间质性肺炎(UIP)模式(调整后HR为5.13,95% CI为1.00-57.36)被认为是RA-ILD患者死亡的风险因素。与无 ILD 的患者相比,RA-ILD 患者的死亡风险较高。与感染相关的死亡是该人群死亡的主要原因。高RA活性、低DLCO和UIP模式与RA-ILD患者的死亡率显著相关。
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Risk factors of mortality in patients with rheumatoid arthritis-associated interstitial lung disease: a single-centre prospective cohort study
To determine the risk factors for mortality in Korean patients with rheumatoid arthritis (RA)-associated interstitial lung disease (ILD) in comparison to patients with RA but without ILD (RA-nonILD). Data were extracted from a single-centre prospective cohort of RA patients with a chest computed tomography scan at an academic referral hospital in Korea. Patients with RA-ILD enroled between May 2017 and August 2022 were selected, and those without ILD were selected as comparators. The mortality rate was calculated, and the causes of each death were investigated. We used Cox proportional hazard regression with Firth’s penalised likelihood method to identify the risk factors for mortality in patients with RA-ILD. A total of 615 RA patients were included: 200 with ILD and 415 without ILD. In the RA-ILD group, there were 15 deaths over 540.1 person-years (PYs), resulting in mortality rate of 2.78/100 PYs. No deaths were reported in the RA-nonILD group during the 1669.9 PYs. The primary causes of death were infection (nine cases) and lung cancer (five cases), with only one death attributed to ILD aggravation. High RA activity (adjusted HR 1.87, CI 1.16–3.10), baseline diffusing capacity for carbon monoxide (DLCO) < 60% (adjusted HR 4.88, 95% CI 1.11–45.94), and usual interstitial pneumonia (UIP) pattern (adjusted HR 5.13, 95% CI 1.00–57.36) were identified as risk factors for mortality in RA-ILD patients. Patients with RA-ILD have an elevated risk of mortality compared with those without ILD. Infection-related deaths are the main causes of mortality in this population. High RA activity, low DLCO, and the UIP pattern are significantly associated with the mortality in patients with RA-ILD.
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来源期刊
CiteScore
8.60
自引率
2.00%
发文量
261
审稿时长
14 weeks
期刊介绍: Established in 1999, Arthritis Research and Therapy is an international, open access, peer-reviewed journal, publishing original articles in the area of musculoskeletal research and therapy as well as, reviews, commentaries and reports. A major focus of the journal is on the immunologic processes leading to inflammation, damage and repair as they relate to autoimmune rheumatic and musculoskeletal conditions, and which inform the translation of this knowledge into advances in clinical care. Original basic, translational and clinical research is considered for publication along with results of early and late phase therapeutic trials, especially as they pertain to the underpinning science that informs clinical observations in interventional studies.
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