Causes of hospital admission and prognostic factors in patients with vasculitides associated with anti-neutrophil cytoplasmic antibodies
Abstract
Background: Few retrospective studies have described the clinical course of patients with ANCA-asocciated vasculitis (AAV) admitted to the hospital, all of them in intensive care units (ICU).Objective: To study the epidemiology, clinical features and outcome of patients with AAV admitted to the hospital, and to identify the prog-nostic factors associated with mortality. Methods: Patients with AAV admitted to the Juan A. Fernández Hos-pital and San Camilo Clinic (Buenos Aires City, Argentina) between January 2011 and December 2013 were included. Results: Thirty four patients [18 (53%) female] with an average 60 ± 12 years old were included. AAV was diagnosed in 9 (26%) patients in the hospital. Microscopic Polyangiitis was the most common AAV. Eighteen (53%) patients were admitted due to active vasculitis. Lung (n=9), kidney (n=6), ear-nose-throat (n=5), peripheral nervous sys-tem (n=5) and skin (n=2) were the organs/systems involved. Other reasons for admission were: infection and metabolic conditions [8 (23.5%) patients each]. Eight (23.5%) patients died, 3 due to active vasculitis, 4 due to infection and 1 patient due to multiorgan failure after pamidronate treatment. Mortality was significantly higher for patients who were admitted in ICU (p=0.001); gender (p=0.69), age (p=0.15), new diagnosis of AAV (p=0.4), BVAS and VDI showed no significant differences between survival and dead patients. The mor-tality was similar (p=0.6) between the patients with active vasculitis and the patients with infections.Conclusion: The main reason for hospitalization in AAV patients was active vasculitis followed by infection. Mortality rate was high and the main causes were infections regardless the diagnosis at admission.References
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