- 期刊
- OpenAccess
Prognostic Factors of Survival in Patients with Dermatomyositis and Polymyositis
多發性肌炎與皮肌炎病患之存活及預後因子分析
摘要
Background: To determine the incidence, characteristics, and prognostic factors of mortality in patients with polymyositis (PM) and dermatomyositis (DM). Materials and Methods: Medical records of 151 PM/DM patients treated at Chang Gung Memorial Hospital between 2000 and 2007 were retrospectively reviewed. Results: Twenty-five (16.6%) of the 151 PM/DM patients had associated cancer. Thirty-two (21.2%) of the 151 PM/DM patients had interstitial lung disease (ILD). During follow-up, 30 (19.9%) patients died. Overall patient cumulative survival rates were 81.0, 77.6, and 74.6% at 1, 2, and 5 years, respectively. In univariate analysis, old age at PM/DM onset, cancer, ILD, DM, diabetes mellitus, low creatine phosphokinase (CPK) level, and use of intravenous immunoglobulin were associated with increased mortality (p=0.018, 0.011, ＜0.001, 0.002, 0.001, 0.009, and 0.007, respectively). Multivariate analysis excluding anti-Jo-1 antibody was performed after adjusting for CPK level. Only ILD (OR=12.93, 95% CI=3.97-42.13, p＜0.001) and cancer (OR=4.10, 95% CI=1.21-13.91, p=0.023) were associated with mortality. If the anti-Jo-1 antibody was included in multivariate analysis (n=80), then ILD (OR=15.40, 95% CI=2.68-88.02, p=0.002) and DM (OR=12.56, 95% CI=1.21-130.62, p=0.034) were associated with increased mortality. Conclusion: This study underlines the high mortality rate that associated with PM/DM. Survival time was significantly shorter for patients with ILD, cancer or DM than those without.
並列摘要
Background: To determine the incidence, characteristics, and prognostic factors of mortality in patients with polymyositis (PM) and dermatomyositis (DM). Materials and Methods: Medical records of 151 PM/DM patients treated at Chang Gung Memorial Hospital between 2000 and 2007 were retrospectively reviewed. Results: Twenty-five (16.6%) of the 151 PM/DM patients had associated cancer. Thirty-two (21.2%) of the 151 PM/DM patients had interstitial lung disease (ILD). During follow-up, 30 (19.9%) patients died. Overall patient cumulative survival rates were 81.0, 77.6, and 74.6% at 1, 2, and 5 years, respectively. In univariate analysis, old age at PM/DM onset, cancer, ILD, DM, diabetes mellitus, low creatine phosphokinase (CPK) level, and use of intravenous immunoglobulin were associated with increased mortality (p=0.018, 0.011, ＜0.001, 0.002, 0.001, 0.009, and 0.007, respectively). Multivariate analysis excluding anti-Jo-1 antibody was performed after adjusting for CPK level. Only ILD (OR=12.93, 95% CI=3.97-42.13, p＜0.001) and cancer (OR=4.10, 95% CI=1.21-13.91, p=0.023) were associated with mortality. If the anti-Jo-1 antibody was included in multivariate analysis (n=80), then ILD (OR=15.40, 95% CI=2.68-88.02, p=0.002) and DM (OR=12.56, 95% CI=1.21-130.62, p=0.034) were associated with increased mortality. Conclusion: This study underlines the high mortality rate that associated with PM/DM. Survival time was significantly shorter for patients with ILD, cancer or DM than those without.