Prevalence and Outcomes of Gastrointestinal Manifestations in an Australian Scleroderma Cohort.

IF 3.7 2区 医学 Q1 RHEUMATOLOGY
Alannah Quinlivan, Dylan Hansen, Wendy Stevens, Laura Ross, Nava Ferdowsi, Susanna M Proudman, Jennifer G Walker, Joanne Sahhar, Gene-Siew Ngian, Diane Apostolopoulos, Lauren V Host, Gabor Major, Chamara Basnayake, Kathleen Morrisroe, Mandana Nikpour
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Abstract

Objective: The gastrointestinal tract (GIT) is the most commonly affected internal organ in systemic sclerosis (SSc). We sought to determine the prevalence and impact of GIT symptoms on survival and patient-reported outcomes.

Methods: A total of 907 consecutive patients from the Australian Scleroderma Cohort Study who had prospectively completed the University of California, Los Angeles, Scleroderma Clinical Trials Consortium Gastrointestinal Tract 2.0 Questionnaire (UCLA GIT) between 2015 and 2021 were included. The associations between UCLA GIT scores and physical function (Scleroderma Health Assessment Questionnaire), quality of life (QoL; Short Form 36), mood (Patient-Reported Outcomes Measurement Information System [PROMIS] anxiety and depression domains), fatigue (Functional Assessment of Chronic Illness Therapy-Fatigue score), and employment were investigated using multivariable population-averaged panel models using generalized estimating equations (GEEs). Kaplan-Meier curves and multivariable Cox proportional hazard regression models were used to evaluate survival according to total UCLA GIT scores.

Results: GIT symptoms were reported in 87% of participants, with 46% to 52% reporting moderate to very severe symptoms of reflux, distension, diarrhea, and constipation. Higher total UCLA GIT scores were associated with worse QoL, physical function, fatigue, anxiety, and depression (P < 0.001). In the multivariable GEE analysis, moderate and severe to very severe total scores, reflux scores, and distension scores were associated with worse physical function, QoL, fatigue, anxiety, and depression compared to mild scores (P < 0.05). Patients with severe total scores and diarrhea scores were more likely to be unemployed compared to those with mild scores (P < 0.05). UCLA GIT total scores were not independently associated with death in our cohort.

Conclusion: GIT manifestations are common in SSc and negatively impact QoL, physical function, and employment but are not directly associated with increased death.

澳大利亚硬皮病队列中胃肠道表现的发病率和结果。
目的:胃肠道(GIT)是系统性硬化症(SSc)中最常受影响的内脏器官。我们试图确定胃肠道症状的患病率及其对生存和患者报告结果的影响。方法:纳入了来自澳大利亚硬皮病队列研究(ASCS)的 907 名连续患者,这些患者在 2015 年至 2021 年期间前瞻性地完成了加州大学洛杉矶分校硬皮病临床试验联盟胃肠道 2.0 问卷(UCLA GIT)。使用广义估计方程(GEE)的多变量人群平均面板模型研究了 UCLA GIT 评分与身体功能(SHAQ)、QoL(SF-36)、情绪(PROMIS 焦虑和抑郁域)、疲劳(FACIT-疲劳评分)和就业之间的关联。根据 UCLA GIT 总分,使用 Kaplan-Meier 曲线和多变量 Cox 比例危险回归模型评估生存率:87%的参与者报告了胃肠道症状,其中46%至52%的参与者报告了中度至非常严重的反流、腹胀、腹泻和便秘症状。较高的 UCLA GIT 总分与较差的 QoL、身体机能、疲劳、焦虑和抑郁有关(p 结论:胃肠道表现在 SSc 中很常见,对 QoL、身体功能和就业有负面影响,但与死亡率的增加没有直接关系。
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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来源期刊
CiteScore
9.40
自引率
6.40%
发文量
368
审稿时长
3-6 weeks
期刊介绍: Arthritis Care & Research, an official journal of the American College of Rheumatology and the Association of Rheumatology Health Professionals (a division of the College), is a peer-reviewed publication that publishes original research, review articles, and editorials that promote excellence in the clinical practice of rheumatology. Relevant to the care of individuals with rheumatic diseases, major topics are evidence-based practice studies, clinical problems, practice guidelines, educational, social, and public health issues, health economics, health care policy, and future trends in rheumatology practice.
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