Predictive risk factors for one-year mortality in idiopathic inflammatory myopathy patients with interstitial lung disease: A retrospective, single-center cohort study.

IF 1.1 Q4 RHEUMATOLOGY
Archives of rheumatology Pub Date : 2024-05-05 eCollection Date: 2024-06-01 DOI:10.46497/ArchRheumatol.2024.10418
Minna Jiang, Xiaohong Wen, Sisi Xia, Yiqun Guo, Yu Bai
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Abstract

Objectives: This study aimed to analyze the risk factors for mortality of idiopathic inflammatory myopathy (IIM) patients admitted with interstitial lung disease (ILD) to guide rapid and accurate judgment of clinical prognosis.

Patients and methods: This retrospective, single-center cohort study was conducted with 135 participants (37 males, 98 females; mean age: 54.8±11.1 years; range, 24 to 85 years) between June 1, 2016, and June 30, 2021. The participants were categorized into the survival group (n=111) and nonsurvivors (n=24) according to whether they survived during the one-year follow-up. The independent risk factors for mortality in one year after discharge were analyzed. Receiver operating characteristic curve analysis was used to determine the accuracy of oxygenation index at baseline combined with pulmonary infection (PI) at follow-up to indicate death in IIM-ILD patients.

Results: Compared to the survival group, nonsurvivors were older (p=0.006) and had a higher proportion of anti-MDA5 (melanoma differentiation-associated protein 5) positivity (p<0.001). The ILD duration was shorter (p=0.006), the oxygenation index was lower (p<0.001), and the intensive care unit occupancy rate (p<0.001) and ventilator utilization rate (p<0.001) were elevated in nonsurvivors compared to the survival group. Oxygenation index at baseline (odds ratio [OR]=1.021, 95% confidence interval [CI]: 1.001-1.023, p=0.040) and PI (clinical judgment) at follow-up (OR=16.471, 95% CI: 1.565-173.365, p=0.020) were found as independent risk factors for death in the year after discharge in IIM inpatients with ILD. An oxygenation index ≤279 mmHg at baseline combined with PI at follow-up exhibited a promising predictive value for all-cause death in IIM-ILD patients within one year.

Conclusion: Oxygenation index at baseline and PI during follow-up were independent risk factors for death of IIM-ILD patients within one year after discharge. Patients with an oxygenation index ≤279 mmHg at baseline had an increased risk of death once they developed PI during the one-year follow-up.

间质性肺病特发性炎症性肌病患者一年死亡率的预测风险因素:一项回顾性单中心队列研究。
研究目的本研究旨在分析因间质性肺病(ILD)入院的特发性炎症性肌病(IIM)患者的死亡风险因素,以指导临床预后的快速准确判断:这项回顾性单中心队列研究在2016年6月1日至2021年6月30日期间对135名参与者(37名男性,98名女性;平均年龄:54.8±11.1岁;范围:24至85岁)进行了研究。根据一年随访期间是否存活,参与者被分为存活组(111 人)和非存活组(24 人)。分析了出院后一年内死亡的独立风险因素。采用接收者操作特征曲线分析法确定基线氧合指数和随访肺部感染(PI)对指示IIM-ILD患者死亡的准确性:结果:与存活组相比,非存活组患者年龄更大(P=0.006),抗MDA5(黑色素瘤分化相关蛋白5)阳性比例更高(P=0.006):基线氧合指数和随访期间的PI是IIM-ILD患者出院后一年内死亡的独立风险因素。基线氧合指数≤279 mmHg的患者在一年随访期间一旦出现PI,死亡风险就会增加。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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