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Survival analysis of patients with dermatomyositis and polymyositis

Analysis of 192 Chinese cases

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Abstract

To estimate the mortality rate and identify factors predicting survival in patients with polymyositis (PM) and dermatomyositis (DM). The medical records of 192 PM/DM patients who were treated at Chang Gung Memorial Hospital from 1999 through 2008 were retrospectively reviewed. The Taiwan National Death Registry (1999–2008) was used to obtain their survival status. Thirty-one (16.1%) of the 192 patients with PM/DM had an associated malignancy; 41 (21.4%) had interstitial lung disease (ILD). During the follow-up period, 55 (28.6%) patients died and the overall cumulative survival rate was 79.3% at 1 year, 75.7% at 2 years, 69.9% at 5 years, and 66.2% at 10 years. In univariate analysis, older age at PM/DM onset, anemia, thrombocytopenia, leukopenia, diabetes mellitus, ILD, cancer, and non-use of azathioprine were associated with higher mortality (p = 0.0172, 0.0484, <0.0001, 0.0008, 0.0001, 0.0036, 0.0010, and 0.0019, respectively). In multivariate Cox regression analysis, thrombocytopenia (hazard ratio [HR] 4.94, 95% confidence interval [CI] 2.60–9.37, p < 0.0001), diabetes mellitus (HR 2.57, 95% CI 1.38–4.80, p < 0.0001), cancer (HR 2.30, 95% CI 1.26–4.22, p = 0.0030), and ILD (HR 1.98, 95% CI 1.11–3.51, p = 0.0182) were positively associated with mortality. Use of azathioprine (HR 0.35, 95% CI 0.16–0.74, p = 0.0064) was negatively associated with mortality. This study confirmed the high mortality rate (28.6%) in PM/DM patients. Survival time was significantly reduced in patients with thrombocytopenia, diabetes mellitus, ILD, and cancer patients than in those without these conditions.

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Acknowledgements

The authors are grateful to Chang Gung Memorial Hospital (Project No. CMRPG390211) and the Ministry of Education of Taiwan (Project No. EMRPD180201) for financially supporting this research. This study is based in part on data from the National Health Insurance Research Database provided by the Bureau of National Health Insurance, Department of Health and managed by National Health Research Institutes (Registered number 99067). The interpretation and conclusions contained herein do not represent those of Bureau of National Health Insurance, Department of Health or National Health Research Institutes.

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Authors and Affiliations

  1. Division of Allergy, Immunology and Rheumatology, Chang Gung Memorial Hospital, 5, Fu-Shin St., Kuei-Shan (333), Tao-Yuan, Taiwan

    Kuang-Hui Yu, Yeong-Jian Jan Wu, Chang-Fu Kuo, Hsiao-Chun Chang, Shue-Fen Luo & Huei-Huang Ho

  2. Chang Gung University, Tao-Yuan, Taiwan

    Kuang-Hui Yu, Yeong-Jian Jan Wu, Chang-Fu Kuo, Shue-Fen Luo, Huei-Huang Ho & I-Jung Chen

  3. Department of Public Health, College of Medicine, and Biostatistics Core Laboratory, Molecular Medicine Research Center, Chang Gung University, Tao-Yuan, Taiwan

    Lai-Chu See

  4. Biostatistics Consulting Center, Department of Public Health, Chang Gung University, Tao-Yuan, Taiwan

    Yu-Ming Shen

  5. School of Medicine, Chang Gung University, Tao-Yuan, Taiwan

    I-Jung Chen

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  1. Kuang-Hui Yu
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Correspondence to Kuang-Hui Yu.

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Yu, KH., Wu, YJ.J., Kuo, CF. et al. Survival analysis of patients with dermatomyositis and polymyositis. Clin Rheumatol 30, 1595–1601 (2011). https://doi.org/10.1007/s10067-011-1840-0

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  • DOI: https://doi.org/10.1007/s10067-011-1840-0

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