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Updated: Jun 10, 2025

Imaging Features of Systemic Sclerosis-Associated Interstitial Lung Disease
Published on: June 16, 2020
Comorbidity burden on mortality in patients with systemic sclerosis
Thomas Fauthoux1, Damien Brisou2, Estibaliz Lazaro3
1Médecine Interne, Hopital Saint-Antoine, Paris, France thomas.fauthoux@aphp.fr.
Insights
Systemic sclerosis patients face high mortality from comorbidities. Neoplasia, cardiovascular diseases, and polypharmacy significantly increase this risk, highlighting the need for a comprehensive comorbidome approach.
Area of Science:
- Rheumatology and Immunology
- Clinical Epidemiology
Background:
- Systemic sclerosis (SSc) is a severe, life-threatening autoimmune disease.
- Mortality in SSc is significantly influenced by co-occurring medical conditions (comorbidities).
- Understanding the 'comorbidome' is crucial for managing SSc patient outcomes.
Purpose of the Study:
- To map the prevalence of comorbidities in Systemic sclerosis patients.
- To investigate the relationship between specific comorbidities and mortality.
- To develop a comprehensive 'comorbidome' for SSc.
Main Methods:
- Retrospective, single-center observational study of 400 SSc patients.
- Data collection included demographics, organ involvement, and 14 predefined comorbidities.
- Survival analysis using Kaplan-Meier curves and Cox regression.
Main Results:
- A total of 74 out of 400 participants (18.5%) died during the study period.
- Neoplasia, cardiovascular diseases, and polypharmacy were significantly associated with increased mortality.
- SSc-specific lung and cardiac involvements were also linked to higher mortality rates.
Conclusions:
- The study successfully constructed the SSc comorbidome, identifying key mortality predictors.
- Cardiovascular diseases, neoplasms, and polypharmacy are critical comorbidities in SSc.
- Further large-scale validation is needed to develop a potential mortality scoring tool for SSc.
Introduction:
Systemic sclerosis (SSc) is a serious life-threatening tissue disease. A significant aspect of its mortality arises from comorbid conditions. Our study aimed at mapping out the prevalence of these comorbidities and their relation to mortality, thus creating a 'comorbidome'.
Methods:
In our retrospective, single-centre observational study, we recorded each patient's data, including demographic informations, vital stats and SSc-related organ involvement, along with the presence or absence of 14 predefined comorbidities. We also documented the dates of their initial and most recent visits. To construct survival curves, we used the Kaplan-Meier method, followed by a Cox regression model for multivariate analysis.
Results:
Our study involved 400 participants, 74 of whom unfortunately passed away. It is important to note that three specific comorbidities showed significant correlation to mortality: neoplasia, cardiovascular diseases and polypharmacy, as well as two SSc-specific organ involvements (lung and cardiac).
Conclusion:
Our research led to the successful creation of the SSc comorbidome. Comorbidities are a major concern for patients suffering from SSc, particularly cardiovascular diseases and neoplasms. Our study highlights the effects of polypharmacy. The resultant comorbidome offers a comprehensive and analytical perspective on this complex issue and underscores the inter-relatedness of the data. Our study, however, was limited by a small sample size. Therefore, to confirm our findings, validation on a larger scale is necessary. This could potentially contribute to the creation of a future mortality scoring tool.
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