FACTORI PREDICTIVI PENTRU DECES ÎN SCLERODERMIA SISTEMICĂ: UN STUDIU LONGITUDINAL.

Background. Systemic sclerosis (SSc) is a complex autoimmune disease that involves various organs and systems and is associated with high mortality and morbidity rates. Objectives. To identify even from the first visit to the physician clinical and non-clinical parameters with predictive value for death, in patients with SSc. Methods. Demographic, clinical and non-clinical data were assessed (at each visit, according to EUSTAR recommendations) for all patients with SSc that visited our clinic between 2004-2012. Statistical analysis was done through SPSS 20.0, using chi-square and uni- and multivariate logistic regression. Results. 96 patients with SSc were included in the study, with a mean follow-up of 4.2±1.6 years. Throughout the follow-up period, there were 13 (13.5%) deaths, of whom 6 (6.2%) were of SSc cause and 7 (7.2%) of non-SSc cause. Sex- and age-adjusted univariate analysis identified the diffuse subset, a modified Rodnan score (mRSS) >14, digital ulcers, restrictive ventilatory syndrome, proteinuria, heart rhythm and conduction anomalies and hypo/ hyperpygmentation of the skin to be associated with increased mortality in all patients. Sex- and age-adjusted multivariate model identified a mRSS >14 and proteinuria as predictors of death. With regard to deaths that can be attributed to SSc, univariate analysis identified a mRSS >14, digital ulcers and proteinuria as predictive factors. Conclusions. The survival rate of patients included in the study was over 86% during a mean follow-up period of 5 years. Several clinical and non-clinical parameters which can be deemed predictive factors for death in patients with SSc were identified. Moreover, these can be detected early, from the patient's first visit to the physician, and can have an important role in developing a management strategy for the patient with SSc. [ABSTRACT FROM AUTHOR]