Epidemiological patterns and in-hospital mortality in ANCA-associated vasculitis: Insights from Spain's National Health Data (2016–2022)

IF 8.3 1区医学 Q1 IMMUNOLOGY

Autoimmunity reviews Pub Date : 2025-06-30 DOI:10.1016/j.autrev.2025.103863

Francisco-Josué Cordero-Pérez , Pablo Martínez-Rodríguez , Luis Arribas-Pérez , David Puertas-Miranda , Carlos-Rafael Pires-Baltazar , Leticia Salcedo-Martín , Juan Antonio Sánchez-Villoria , Erik Gabriel Díaz-Ávila , Hugo-Guillermo Ternavasio-De La Vega , Miguel Marcos , Antonio-Javier Chamorro

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Abstract

Background

ANCA-associated vasculitis (AAV), including granulomatosis with polyangiitis (GPA), microscopic polyangiitis (MPA), and eosinophilic granulomatosis with polyangiitis (EGPA), is a systemic autoimmune disease. This study represents the first large-scale analysis of AAV hospitalisation rates and in-hospital mortality trends in Spain.

Methods

A retrospective longitudinal analysis of AAV-related hospital admissions between 2016 and 2022 was conducted using the ICD-10 codes from the Minimum Basic Dataset (MBDS) of the Spanish National Health System. Statistical analyses were performed, including odds ratios, Student's t-tests, and Mantel-Haenszel trend tests.

Results

Among 5753 AAV episodes, GPA was the most frequent subtype (53.9 %), followed by MPA (31.5 %) and EGPA (14.6 %). AAV episodes were more frequent in older patients (> 65 years) than in other hospital episodes (62.9 % vs. 38.9 %; OR: 2.66, 95 %CI: 2.51–2.80; P < 0.001). Larger hospitals accounted for more AAV episodes, longer hospital stays, and higher costs. MPA had the highest mortality rate (7.2 % vs. 4.9 %; OR: 1.52, 95 % CI: 1.27–1.79; P < 0.001), particularly in patients over 65 years (83.1 % vs. 61.8 %; OR: 3.04, 95 % CI: 2.47–3.75; P < 0.001) compared with the other AAV. In the GPA group, renal involvement significantly increased mortality compared to GPA cases without renal involvement (6.6 % vs. 4.6 %; OR: 1.46, 95 % CI: 1.16–1.83; P = 0.011). Notably, the relative risk of AAV-related deaths increased over the study period (Z = 2.77, P < 0.01).

Conclusion

AAV, particularly MPA, is associated with increased hospital mortality, particularly among older adults and patients with renal involvement.

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anca相关血管炎的流行病学模式和住院死亡率：来自西班牙国家健康数据的见解（2016-2022）

anca相关性血管炎（AAV），包括肉芽肿病合并多血管炎（GPA）、显微多血管炎（MPA）和嗜酸性肉芽肿病合并多血管炎（EGPA），是一种全身性自身免疫性疾病。该研究首次对西班牙AAV住院率和住院死亡率趋势进行了大规模分析。方法采用西班牙国家卫生系统最低基本数据集（MBDS）的ICD-10代码，对2016 - 2022年aav相关住院病例进行回顾性纵向分析。进行统计分析，包括优势比、学生t检验和Mantel-Haenszel趋势检验。结果5753例AAV发作中，GPA亚型最多（53.9%），MPA亚型次之（31.5%），EGPA亚型次之（14.6%）。AAV发作在老年患者中更为频繁(>；65岁)比其他医院发作(62.9%对38.9%；Or: 2.66, 95% ci: 2.51-2.80；P & lt;0.001)。大型医院的AAV发作次数更多，住院时间更长，费用更高。MPA的死亡率最高(7.2% vs. 4.9%；Or: 1.52, 95% ci: 1.27-1.79；P & lt;0.001)，尤其是65岁以上的患者(83.1% vs. 61.8%；Or: 3.04, 95% ci: 2.47-3.75；P & lt;0.001)，与其他AAV相比。在GPA组中，与没有肾脏受累的GPA患者相比，肾脏受累的死亡率显著增加(6.6% vs. 4.6%；Or: 1.46, 95% ci: 1.16-1.83；p = 0.011)。值得注意的是，在研究期间，aav相关死亡的相对风险增加(Z = 2.77, P <；0.01)。结论：aav，特别是MPA，与医院死亡率增加有关，特别是在老年人和肾脏受累患者中。

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

Autoimmunity reviews 医学-免疫学

CiteScore

24.70

自引率

4.40%

发文量

164

审稿时长

21 days

期刊介绍： Autoimmunity Reviews is a publication that features up-to-date, structured reviews on various topics in the field of autoimmunity. These reviews are written by renowned experts and include demonstrative illustrations and tables. Each article will have a clear "take-home" message for readers. The selection of articles is primarily done by the Editors-in-Chief, based on recommendations from the international Editorial Board. The topics covered in the articles span all areas of autoimmunology, aiming to bridge the gap between basic and clinical sciences. In terms of content, the contributions in basic sciences delve into the pathophysiology and mechanisms of autoimmune disorders, as well as genomics and proteomics. On the other hand, clinical contributions focus on diseases related to autoimmunity, novel therapies, and clinical associations. Autoimmunity Reviews is internationally recognized, and its articles are indexed and abstracted in prestigious databases such as PubMed/Medline, Science Citation Index Expanded, Biosciences Information Services, and Chemical Abstracts.