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Survival in Swedish patients with systemic sclerosis : A nationwide population-based matched cohort study

Bairkdar, Majd ; Chen, Enoch Yi Tung ; Dickman, Paul W. ; Hesselstrand, Roger LU ; Westerlind, Helga and Holmqvist, Marie (2023) In Rheumatology (United Kingdom) 62(3). p.1170-1178
Abstract

Objectives: To conduct the first-ever nationwide, population-based cohort study investigating survival patterns of all patients with incident SSc in Sweden compared with matched individuals from the Swedish general population. Methods: We used the National Patient Register to identify patients with incident SSc diagnosed between 2004 and 2015 and the Total Population Register to identify comparators (1:5), matched on sex, birth year and residential area. We followed them until death, emigration or the end of 2016. Follow-up of the general population comparators started the same date as their matched patients were included. We estimated all-cause survival using the Kaplan-Meier method, crude mortality rates and hazard ratios (HRs) using... (More)

Objectives: To conduct the first-ever nationwide, population-based cohort study investigating survival patterns of all patients with incident SSc in Sweden compared with matched individuals from the Swedish general population. Methods: We used the National Patient Register to identify patients with incident SSc diagnosed between 2004 and 2015 and the Total Population Register to identify comparators (1:5), matched on sex, birth year and residential area. We followed them until death, emigration or the end of 2016. Follow-up of the general population comparators started the same date as their matched patients were included. We estimated all-cause survival using the Kaplan-Meier method, crude mortality rates and hazard ratios (HRs) using flexible parametric models. Results: We identified 1139 incident patients with SSc and 5613 matched comparators. The median follow-up was 5.0 years in patients with SSc and 6.0 years for their comparators. During follow-up, 268 deaths occurred in patients with SSc and 554 in their comparators. The 5-year survival was 79.8% and the 10-year survival was 67.7% among patients with SSc vs 92.9% and 84.8%, respectively, for the comparators (P < 0.0001). The mortality rate in patients with SSc was 42.1 per 1000 person-years and 15.8 per 1000 person-years in their comparators, corresponding to an HR of 3.7 (95% CI 2.9, 4.7) at the end of the first year of follow-up and 2.0 (95% CI 1.4, 2.8) at the end of the follow-up period. Conclusion: Despite advances in understanding the disease and in diagnostic methods over the past decades, survival is still severely impacted in Swedish patients diagnosed with SSc between 2004 and 2015.

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author
; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
mortality, SSc, survival
in
Rheumatology (United Kingdom)
volume
62
issue
3
pages
9 pages
publisher
Oxford University Press
external identifiers
  • pmid:35984290
  • scopus:85164310711
ISSN
1462-0324
DOI
10.1093/rheumatology/keac474
language
English
LU publication?
yes
id
a776d7d1-aedc-43fa-8eac-1e20819cabc2
date added to LUP
2023-09-20 14:38:08
date last changed
2024-04-19 01:29:23
@article{a776d7d1-aedc-43fa-8eac-1e20819cabc2,
  abstract     = {{<p>Objectives: To conduct the first-ever nationwide, population-based cohort study investigating survival patterns of all patients with incident SSc in Sweden compared with matched individuals from the Swedish general population. Methods: We used the National Patient Register to identify patients with incident SSc diagnosed between 2004 and 2015 and the Total Population Register to identify comparators (1:5), matched on sex, birth year and residential area. We followed them until death, emigration or the end of 2016. Follow-up of the general population comparators started the same date as their matched patients were included. We estimated all-cause survival using the Kaplan-Meier method, crude mortality rates and hazard ratios (HRs) using flexible parametric models. Results: We identified 1139 incident patients with SSc and 5613 matched comparators. The median follow-up was 5.0 years in patients with SSc and 6.0 years for their comparators. During follow-up, 268 deaths occurred in patients with SSc and 554 in their comparators. The 5-year survival was 79.8% and the 10-year survival was 67.7% among patients with SSc vs 92.9% and 84.8%, respectively, for the comparators (P &lt; 0.0001). The mortality rate in patients with SSc was 42.1 per 1000 person-years and 15.8 per 1000 person-years in their comparators, corresponding to an HR of 3.7 (95% CI 2.9, 4.7) at the end of the first year of follow-up and 2.0 (95% CI 1.4, 2.8) at the end of the follow-up period. Conclusion: Despite advances in understanding the disease and in diagnostic methods over the past decades, survival is still severely impacted in Swedish patients diagnosed with SSc between 2004 and 2015.</p>}},
  author       = {{Bairkdar, Majd and Chen, Enoch Yi Tung and Dickman, Paul W. and Hesselstrand, Roger and Westerlind, Helga and Holmqvist, Marie}},
  issn         = {{1462-0324}},
  keywords     = {{mortality; SSc; survival}},
  language     = {{eng}},
  number       = {{3}},
  pages        = {{1170--1178}},
  publisher    = {{Oxford University Press}},
  series       = {{Rheumatology (United Kingdom)}},
  title        = {{Survival in Swedish patients with systemic sclerosis : A nationwide population-based matched cohort study}},
  url          = {{http://dx.doi.org/10.1093/rheumatology/keac474}},
  doi          = {{10.1093/rheumatology/keac474}},
  volume       = {{62}},
  year         = {{2023}},
}