Adult-onset Still's disease with elderly onset: results from a multicentre study
Adult-onset Still's disease with elderly onset: results from a multicentre study
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DOI：
10.55563/clinexprheumatol/0215kv
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发表时间：
2022-08-01
影响因子：
3.7
通讯作者：
Ruscitti, P.
中科院分区：
文献类型：
--
作者：
Di Cola, I.;Di Muzio, C.;Ruscitti, P.
目的 在本研究中，我们旨在描述老年发病的成人斯蒂尔病（AOSD）患者的临床特征、危及生命的并发症发生情况和死亡率。方法 对 Gruppo Italiano di Ricerca in Reumatologia Clinica e Sperimentale (GIRRCS) 队列中的前瞻性随访 AOSD 患者进行多中心回顾性研究。结果 在 221 名接受评估的患者中，37 名（16.7%）患者发病年龄超过 60 岁。与年轻患者相比，这些患者的心包炎患病率 (p=0.008)、合并症 (p < 0.0001) 和死亡率 (p=0.023) 较高。在单变量（HR：1.02，95％CI：1.01-1.03，p = 0.007）和多变量分析（HR：1.02，95％CI：1.01-1.04，p = 0.007）中，年龄预测浆膜炎的存在。在单变量（HR：1.03，95％CI：1.01-1.05，p=0.017）和多变量分析（HR：1.03，95％CI：1.00-1.05，p=0.048）中，年龄也是实质肺疾病的重要预测因子。此外，年龄仅在单变量分析中成为多循环模式的负预测因子（HR：0.99，95％CI：0.97-1.00，p = 0.048）。最后，在单变量（HR：1.03，95％CI：1.00-1.06，p = 0.034）和多变量分析（HR：1.05，95％CI：1.01-1.08，p = 0.012）中，年龄显着预测死亡率。结论 我们的队列描述了老年 AOSD 患者的临床特征。尽管老年患者和年轻患者的主要临床特征相似，但发病时年龄超过 60 岁的患者的特点是浆膜炎、合并症（主要是心脏代谢性疾病）的患病率增加，并且死亡率较高。年龄可预测实质肺疾病和死亡率的存在，并且可以被视为 AOSD 的负面预后因素。
Objective In this study, we aimed to describe the clinical characteristics, life-threatening complications occurrence, and mortality of adult-onset Still's disease (AOSD) patients with elderly onset. Methods A multicentre retrospective study of prospectively followed-up AOSD patients included in Gruppo Italiano di Ricerca in Reumatologia Clinica e Sperimentale (GIRRCS) cohort was performed. Results Out of 221 assessed patients, 37 (16.7%) had an onset of the disease aged over 60 years. When compared with younger patients, these were characterised by a higher prevalence of pericarditis (p=0.008), comorbidities (p < 0.0001), and mortality (p=0.023). Age predicted the presence of serositis in both univariate (HR: 1.02, 95%CI: 1.01-1.03, p=0.007) and multivariate analyses (HR: 1.02, 95%CI: 1.01-1.04, p=0.007). Age was also a significant predictor of parenchymal lung disease in both univariate (HR: 1.03, 95%CI: 1.01-1.05, p=0.017) and multivariate analyses (HR: 1.03, 95%CI: 1.00-1.05, p=0.048). Furthermore, age resulted to be a negative predictor of polycyclic pattern only in univariate analysis (HR: 0.99, 95%CI: 0.97-1.00, p=0.048). Finally, age significantly predicted the mortality in both univariate (HR: 1.03, 95%CI: 1.00-1.06, p=0.034) and multivariate analyses (HR: 1.05, 95%CI: 1.01-1.08, p=0.012). Conclusion Clinical features of AOSD patients in the elderly were described in our cohort. Although the main clinical characteristics were similar comparing older and younger patients, patients aged over 60 years at disease onset were characterised by an increased prevalence of serositis, comorbidities, mostly cardiometabolic, and a higher mortality rate. Age predicted the presence of parenchymal lung disease and mortality, and it could be considered a negative prognostic factor in AOSD.