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Published on: September 22, 2020
Predictive factors for mortality in elderly Japanese patients with severe microscopic polyangiitis: A retrospective
Yoshiyuki Abe1, Naoto Tamura1, Kwang-Seok Yang2
1a Department of Internal Medicine and Rheumatology , Juntendo University School of Medicine , Tokyo , Japan.
Purpose:
To determine mortality and its predictive factors in elderly Japanese patients with severe microscopic polyangiitis (MPA).
Method:
This retrospective single-center study determined the mortality of 52 patients with MPA who were admitted to our geriatric medical center from 2002 to 2014. The variables at baseline, including patient demographics, clinical characteristics, and treatment, were analyzed for their association with mortality.
Result:
Mean age at onset of MPA was 73.2 years, and the one-year survival rate was 65.9%. Relapse was observed in 32.7%. Among variables at diagnosis, age, cardiomyopathy, central nervous system (CNS) involvement, alveolar hemorrhage, disease severity, the 1996 Five-Factor Score (FFS), and the 2009 FFS were associated with mortality in univariate analysis. Cardiomyopathy, CNS involvement, age >65 years, disease severity, Birmingham Vasculitis Activity Score, the 1996 FFS, and the 2009 FFS were associated with relapse-free survival in univariate analysis.
Conclusion:
We investigated mortality and relapse-free survival and their predictive factors in elderly Japanese patients with severe MPA. Age, disease severity, the 1996 FFS, and the 2009 FFS at diagnosis were prognostic factors for both mortality and relapse-free survival.
Insights
Mortality in elderly Japanese patients with severe microscopic polyangiitis (MPA) is significant, with age and disease severity being key predictors. The 1996 and 2009 Five-Factor Scores also indicate prognosis for survival and relapse.
Area of Science:
- Geriatric Medicine
- Rheumatology
- Internal Medicine
Background:
- Microscopic polyangiitis (MPA) is a severe systemic vasculitis.
- Elderly patients often present with unique challenges and prognoses in MPA.
Purpose of the Study:
- To determine mortality rates in elderly Japanese patients diagnosed with severe microscopic polyangiitis (MPA).
- To identify predictive factors associated with mortality and relapse-free survival in this population.
Main Methods:
- A retrospective single-center study analyzed 52 elderly Japanese MPA patients from 2002 to 2014.
- Baseline demographics, clinical characteristics, and treatment data were assessed for prognostic value.
Main Results:
- The mean age at MPA onset was 73.2 years, with a one-year survival rate of 65.9%.
- Significant predictors of mortality included age, cardiomyopathy, central nervous system (CNS) involvement, alveolar hemorrhage, disease severity, and Five-Factor Scores (FFS).
- Relapse-free survival was associated with cardiomyopathy, CNS involvement, age >65, disease severity, and FFS scores.
Conclusions:
- Age, disease severity, and both the 1996 and 2009 FFS at diagnosis are crucial prognostic factors for mortality and relapse-free survival in elderly Japanese MPA patients.
- These findings highlight the importance of early risk stratification and tailored management strategies.
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