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

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...

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Autores principales: Bairkdar, Majd, Chen, Enoch Yi-Tung, Dickman, Paul W, Hesselstrand, Roger, Westerlind, Helga, Holmqvist, Marie
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9977125/
https://www.ncbi.nlm.nih.gov/pubmed/35984290
http://dx.doi.org/10.1093/rheumatology/keac474
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author Bairkdar, Majd
Chen, Enoch Yi-Tung
Dickman, Paul W
Hesselstrand, Roger
Westerlind, Helga
Holmqvist, Marie
author_facet Bairkdar, Majd
Chen, Enoch Yi-Tung
Dickman, Paul W
Hesselstrand, Roger
Westerlind, Helga
Holmqvist, Marie
author_sort Bairkdar, Majd
collection PubMed
description 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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spelling pubmed-99771252023-03-02 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 Westerlind, Helga Holmqvist, Marie Rheumatology (Oxford) Clinical Science 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. Oxford University Press 2022-08-19 /pmc/articles/PMC9977125/ /pubmed/35984290 http://dx.doi.org/10.1093/rheumatology/keac474 Text en © The Author(s) 2022. Published by Oxford University Press on behalf of the British Society for Rheumatology. https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Clinical Science
Bairkdar, Majd
Chen, Enoch Yi-Tung
Dickman, Paul W
Hesselstrand, Roger
Westerlind, Helga
Holmqvist, Marie
Survival in Swedish patients with systemic sclerosis: a nationwide population-based matched cohort study
title Survival in Swedish patients with systemic sclerosis: a nationwide population-based matched cohort study
title_full Survival in Swedish patients with systemic sclerosis: a nationwide population-based matched cohort study
title_fullStr Survival in Swedish patients with systemic sclerosis: a nationwide population-based matched cohort study
title_full_unstemmed Survival in Swedish patients with systemic sclerosis: a nationwide population-based matched cohort study
title_short Survival in Swedish patients with systemic sclerosis: a nationwide population-based matched cohort study
title_sort survival in swedish patients with systemic sclerosis: a nationwide population-based matched cohort study
topic Clinical Science
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9977125/
https://www.ncbi.nlm.nih.gov/pubmed/35984290
http://dx.doi.org/10.1093/rheumatology/keac474
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