Short-term survival analysis of predictive factors associated with mortality in 92 patients with polymyositis and dermatomyositis

Abstract

Abstract: AIM : To investigate the risk factors on survival and prognosis of polymyositis/dermatomyositis(PM/DM).METHODS: The clinical and laboratory data of 101 PM/DM patients from July 2006 to July 2013 in Yijishan Hospital were collected, 9 cases were lost. The 92 patients were divided into a death group and a non-death group. The clinical feature and prognosis were analyzed retrospectively. The clinical and laboratory data were analyzed by using the SPSS 16.0 software. Survival analysis and COX regression were performed to analyze the prognosis and related risk factors for 92 patients followed up.RESULTS:The 92 patients with PM/DM comprised 29 males and 63 females. The idiopathic DM was 51 cases, PM was 41cases. During the follow-up period, 15 patients died, 4 patients with PM, 11 patients with DM. Compared with the non-death group, the age in the death group was markedly older [ (59.1±10.6) years vs (44.3±12.9) years], the median duration [9(3-123) months vs 46(4-174)months, χ² =-3.251, P=0.001] was significantly shorter. The serum levels of ALB [(31.9±4.3) g/L vs (37.4±6.1) g/L, t=2.712, P=0.008], ESR [(46.1±32.6) mm/h vs (30.61±24.9) mm/h, t=2.031, P=0.045] and the serum levels of CRP [(32.5±25.4) mg/L vs (18.0±11.7) mg/L, t=2.263, P=0.026] were statistically different between the two groups. The incidence of ILD [11/15 vs 29/77, χ²=6.56, P=0.010], heart impairment (9/15 vs 24/77, χ²=4.53, P=0.033) and lung infection(10/15 vs 24/77, χ²=5.35, P=0.021)were significantly higher in the death group. Survival estimates in the whole group at 1, 5 and 10 years was 88.7%, 82.3%, 59.5%, respectively.The unfavourable prognostic factors were increased age(χ²=14.128, P<0.001, RR=1.102, 95%CI 1.048-1.160), ILD(χ²=4.642, P=0.031, RR=0.284, 95%CI 0.090-0.893), low ALB level(χ²=7.543, P=0.006, RR=0.890, 95%CI 0.819-0.967), heart impairment(χ²=4.980, P=0.026, RR=0.306, 95%CI 0.108-0.866) and lung infection (χ²=5.451 P=0.020, RR=0.277, 95%CI 0.095-0.140) by multivariate COX regression analysis.CONCLUSION: Patients in the death group showed older age, shorter duration, lower ALB level and higher incidence of ILD , heart impairment and lung infection than in the non-death group. Increased age, low ALB level and complicated ILD, heart impairment, lung infection were poor prognosis factors of PM/DM patients.

Key words: polymyositis, dermatomyositis, survival anlysis, risk factor

CLC Number:

R593.26

SHENG Jun, LU Jin-ming, XUAN Dan, QIANG Fu-yong, XU Liang. Short-term survival analysis of predictive factors associated with mortality in 92 patients with polymyositis and dermatomyositis[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2014, 19(6): 674-679.

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