TY - JOUR
T1 - Infections Are Leading Cause of In-Hospital Mortality in Indian Patients With Inflammatory Myopathy
AU - Muhammed, Hafis
AU - Gupta, Latika
AU - Zanwar, Abhishek Arvind
AU - Misra, Durga P
AU - Lawrence, Able
AU - Agarwal, Vikas
AU - Aggarwal, Amita
AU - Misra, Ramnath
N1 - Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2021/4/1
Y1 - 2021/4/1
N2 - OBJECTIVES: We explored causes of in-hospital mortality in patients with inflammatory myositis at a tertiary care center in Northern India.METHODS: Records of adults and children diagnosed with dermatomyositis (DM), polymyositis, or anti-synthetase syndrome (ASSD) who died between 2000 and 2018 were reviewed, and causes of death were determined.RESULTS: Of the 38 patients, 20 had DM (including 2 clinically amyopathic DM), 4 juvenile DM, 12 polymyositis, whereas 2 had ASSD. Median age at death was 42.0 (interquartile range, 32.8-52.5) years. Median disease duration at death was 18.5 (interquartile range, 2.0-23.5) months. Twenty-four (63.2%) had infection as the primary cause of death. Other causes of death included pharyngeal muscle weakness and aspiration (n = 6), myocarditis (n = 2), respiratory failure (n = 2), cerebral bleed (n = 2), and pulmonary embolism (n = 1). One patient succumbed to rapidly progressive interstitial lung disease, whereas another patient with ASSD died following respiratory distress after rituximab infusion. In post hoc analysis, although thrombocytopenia appeared to be a risk factor for early mortality (odds ratio, 13.3; 95% confidence interval, 1.4-123.8; p = 0.01), this was not supported in the multivariate analysis.CONCLUSIONS: Infections are the most common cause of in-hospital mortality in myositis patients.
AB - OBJECTIVES: We explored causes of in-hospital mortality in patients with inflammatory myositis at a tertiary care center in Northern India.METHODS: Records of adults and children diagnosed with dermatomyositis (DM), polymyositis, or anti-synthetase syndrome (ASSD) who died between 2000 and 2018 were reviewed, and causes of death were determined.RESULTS: Of the 38 patients, 20 had DM (including 2 clinically amyopathic DM), 4 juvenile DM, 12 polymyositis, whereas 2 had ASSD. Median age at death was 42.0 (interquartile range, 32.8-52.5) years. Median disease duration at death was 18.5 (interquartile range, 2.0-23.5) months. Twenty-four (63.2%) had infection as the primary cause of death. Other causes of death included pharyngeal muscle weakness and aspiration (n = 6), myocarditis (n = 2), respiratory failure (n = 2), cerebral bleed (n = 2), and pulmonary embolism (n = 1). One patient succumbed to rapidly progressive interstitial lung disease, whereas another patient with ASSD died following respiratory distress after rituximab infusion. In post hoc analysis, although thrombocytopenia appeared to be a risk factor for early mortality (odds ratio, 13.3; 95% confidence interval, 1.4-123.8; p = 0.01), this was not supported in the multivariate analysis.CONCLUSIONS: Infections are the most common cause of in-hospital mortality in myositis patients.
KW - Adult
KW - Child
KW - Dermatomyositis/complications
KW - Hospital Mortality
KW - Humans
KW - Myositis/diagnosis
KW - Polymyositis/diagnosis
KW - Retrospective Studies
U2 - 10.1097/RHU.0000000000001214
DO - 10.1097/RHU.0000000000001214
M3 - Article
C2 - 31804256
SN - 1076-1608
VL - 27
SP - 114
EP - 119
JO - Journal of Clinical Rheumatology
JF - Journal of Clinical Rheumatology
IS - 3
ER -
