Title :

Characteristics and risk factors for poor outcome in patients with systemic vasculitis involving the gastrointestinal tract

Author(s) :

Gendreau, Segolene [Auteur]
Service de médecine interne et centre de référence des maladies rares [CHU Cochin]
Porcher, Raphael [Auteur]
Centre for Research in Epidemiology and Statistics | Centre de Recherche Épidémiologie et Statistiques [CRESS (U1153 / UMR_A 1125)]
Hôpital Hôtel-Dieu [Paris]
Thoreau, Benjamin [Auteur]
Hôpital Cochin [AP-HP]
Paule, Romain [Auteur]
Hôpital Foch [Suresnes]
Maurier, Francois [Auteur]
Centre hospitalier régional Metz-Thionville [CHR Metz-Thionville]
Goulenok, Tiphaine [Auteur]
AP-HP - Hôpital Bichat - Claude Bernard [Paris]
Frumholtz, Laure [Auteur]
Service de Dermatologie [AP-HP Hôpital Saint-Louis]
Bernigaud, Charlotte [Auteur]
Hôpital Henri Mondor
Ingen-Housz-Oro, Saskia [Auteur]
Hôpital Henri Mondor
Service de dermatologie [Mondor]
Mekinian, Arsene [Auteur]
CHU Saint-Antoine [AP-HP]
Audemard-Verger, Alexandra [Auteur]
Centre Hospitalier Régional Universitaire de Tours [CHRU Tours]
Gaillet, Antoine [Auteur]
AP-HP - Hôpital Bichat - Claude Bernard [Paris]
Perard, Laurent [Auteur]
Centre hospitalier Saint Joseph - Saint Luc [Lyon]
Samson, Maxime [Auteur]
Service de médecine interne et immunologie clinique (SOC 1) [CHU de Dijon]
CHU Dijon
Sonneville, Romain [Auteur]
AP-HP - Hôpital Bichat - Claude Bernard [Paris]
Arlet, Jean-Benoit [Auteur]
Hôpital Européen Georges Pompidou [APHP] [HEGP]
Mirouse, Adrien [Auteur]
Hopital Saint-Louis [AP-HP] [AP-HP]
Kahn, Jean-Emmannuel [Auteur]
Institut de Recherche Translationnelle sur l'Inflammation (INFINITE) - U1286
Charpentier, Julien [Auteur]
Hachulla, Eric [Auteur]
Institut de Recherche Translationnelle sur l'Inflammation (INFINITE) - U1286
Hummel, Aurelie [Auteur]
Hôpital Necker - Enfants Malades [AP-HP]
Département de Néphrologie [CHU Necker]
Pires, Thomas [Auteur]
Centre Hospitalier Universitaire de Bordeaux [CHU Bordeaux]
Carron, Pierre-Louis [Auteur]
Centre Hospitalier Universitaire [CHU Grenoble] [CHUGA]
Durel, Cecile-Audrey [Auteur]
Hôpital Edouard Herriot [CHU - HCL]
Jourde, Wendy [Auteur]
Centre Hospitalier Universitaire de Bordeaux [CHU Bordeaux]
Puechal, Xavier [Auteur]
Hôpital Cochin [AP-HP]
Lega, Jean-Christophe [Auteur]
Hôpital Edouard Herriot [CHU - HCL]
Sarrot-Reynauld, Francoise [Auteur]
Centre Hospitalier Universitaire [CHU Grenoble] [CHUGA]
Tieulie, Nathalie [Auteur]
Centre Hospitalier Universitaire de Nice [CHU Nice]
Diot, Elisabeth [Auteur]
Centre Hospitalier Régional Universitaire de Tours [CHRU Tours]
Guillevin, Loic [Auteur]
Hôpital Cochin [AP-HP]
Terrier, Benjamin [Auteur]
Hôpital Cochin [AP-HP]

Journal title :

Seminars in Arthritis and Rheumatism

Abbreviated title :

Semin Arthritis Rheum

Volume number :

51

Pages :

436-441

Publication date :

2021-03-03

ISSN :

1532-866X

Keyword(s) :

Gastrointestinal tract
Systemic vasculitis
Risk factors
intestinal ischemia

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

Gastrointestinal (GI) involvement was described to be a poor prognostic factor in systemic necrotizing vasculitis. Its prognostic significance may vary according to clinical presentation and vasculitis subtype. This study ...
Show more >Gastrointestinal (GI) involvement was described to be a poor prognostic factor in systemic necrotizing vasculitis. Its prognostic significance may vary according to clinical presentation and vasculitis subtype. This study investigated risk-factors associated to poor outcome in GI-involvement of vasculitis. Patients with systemic vasculitis as defined by the 2012 Chapel Hill Consensus Conference and presenting with GI involvement were retrospectively included. Baseline characteristics, treatments and outcome were recorded. Primary endpoint was a composite of admission to intensive care unit (ICU), emergency surgical procedure, or death. Two hundred and thirteen patients were included. Vasculitis were distributed as follows: 41% IgA vasculitis, 27% ANCA-associated vasculitis, 17% polyarteritis nodosa (PAN), and 15% other vasculitis. Eighty-three (39%) patients fulfilled the composite primary endpoint within 6 months. Predictive factors associated with the primary endpoint included PAN subtype (OR 3.08, 95% CI 1.29-7.34), performance status (OR 1.40, 1.05-1.87), use of morphine (OR 2.51, 0.87-7.24), abdominal guarding (OR 3.08, 1.01-9.37), ileus (OR 2.29, 0.98-5.32), melena (OR 2.74, 1.17-6.42), increased leukocytes (per G/L, OR 1.05, 1.00-1.10), low hemoglobin (per g/dL, OR 0.80, 0.71-0.91) and increased CRP (log mg/L, OR 1.21, 0.94-1.56). A risk prediction model for the achievement of primary endpoint had a very good performance [C-statistics 0.853 (0.810 to 0.895], and for overall survival as well. Vasculitis presenting with GI involvement have a poor outcome in more than one third of cases. An easy-to-use risk prediction model had a very good performance to predict the admission to ICU, emergency surgical procedure, or death.Show less >

Language :

Anglais

Peer reviewed article :

Oui

Audience :

Internationale

Popular science :

Non

Administrative institution(s) :

CHU Lille
Inserm
Université de Lille

Collections :

• Institut de Recherche Translationnelle sur l'Inflammation (INFINITE) - U1286

Submission date :

2021-07-06T12:50:47Z
2024-03-01T16:00:59Z