Predicting mortality in systemic Wegener's granulomatosis: A survival analysis based on 93 patients
Open Access
- 5 February 2004
- journal article
- research article
- Published by Wiley in Arthritis Care & Research
- Vol. 51 (1), 83-91
- https://doi.org/10.1002/art.20082
Abstract
Objective To determine predictors of survival of patients with systemic Wegener's granulomatosis (WG). Methods We retrospectively studied 93 patients (median age 52 years, male/female ratio 1.7) with systemic WG. All subjects received cytotoxic drugs. Survival was evaluated as a function of the main clinical and laboratory parameters and 2 disease activity scores assessed at diagnosis. Statistical analyses used the multivariate Cox proportional hazards regression model. Results The mean followup was 4.5 years; 25 (27%) patients died. According to univariate analysis, a pejorative prognostic value was attributed to serum creatinine >160 μmole/liter (P < 0.001); age >52 years (P < 0.002); absence of ear, nose, and throat (ENT) involvement (P < 0.001); and hemoglobin ≤11.8 gm/dl (P = 0.02). Multivariate analysis retained age >52 years (hazard ratio [HR] = 3.40, P = 0.04) as an independent predictor of poor outcome, whereas the presence of ENT involvement was associated with a longer survival (HR = 0.31, P = 0.02). Conclusion Our results suggest that an older age and the absence of ENT involvement at diagnosis independently predict an increased risk of mortality for WG patients. These findings could indicate that the prognosis of WG might be governed by the balance between the granulomatosis as opposed to the vasculitic disease process.Keywords
This publication has 29 references indexed in Scilit:
- A prospective, multicenter, randomized trial comparing steroids and pulse cyclophosphamide versus steroids and oral cyclophosphamide in the treatment of generalized wegener's granulomatosisArthritis & Rheumatism, 1997
- Small-Vessel VasculitisThe New England Journal of Medicine, 1997
- Therapy for the maintenance of remission in sixty‐five patients with generalized Wegener's granulomatosis. Methotrexate versus trimethoprim/sulfamethoxazoleArthritis & Rheumatism, 1996
- An analysis of forty‐two wegener's granulomatosis patients treated with methotrexate and prednisoneArthritis & Rheumatism, 1995
- Wegener's granulomatosis: clinical features and prognosis in 37 patientsAustralian and New Zealand Journal of Medicine, 1993
- Wegener Granulomatosis: An Analysis of 158 PatientsAnnals of Internal Medicine, 1992
- Death and functional outcome after spontaneous intracerebral hemorrhage. A prospective study of 166 cases using multivariate analysis.Stroke, 1991
- The American College of Rheumatology 1990 criteria for the classification of wegener's granulomatosisArthritis & Rheumatism, 1990
- Giant-cell Granuloma of the Respiratory Tract (Wegener's Granulomatosis)BMJ, 1958
- Nonparametric Estimation from Incomplete ObservationsJournal of the American Statistical Association, 1958