The Survival Rate and Death Cause Analysis of Patients with Polymyositis and Dermatomyositis_West China Medical Journal

Authors：

 DONGJian-ling , ZOUJin-mei , ZHANGYu , TIANLan , YANGJing

Department of Rheumatology, the Central Hospital of Mianyang, Mianyang, Sichuan 621000, P. R. China;

Corresponding author：

Keywords：

Polymyositis; Polymyositis; Death; Follow up

DOI：

10.7507/1002-0179.20140210

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Objective To study the survival rate and death cause of patients with polymyositis (PM) and dermatomyositis (DM). Methods Based on the Bohan and Peter diagnosis standard, DM (n=52) and PM (n=98) hospitalized patients between January 1, 2008 and January 1, 2013 were chosen to be followed up to January 2013, or to their death. Sex, age, disease entities, course of the disease, muscle creatine enzyme, interstitial lung disease, connective tissue diseases, lung infection, cardiac involvement, respiratory muscle paralysis, JO-1 antibody, hypoalbuminemia, tumor, and long-term hormone and immune inhibitor treatment were the influencing factors of death. Results Thirty-eight patients died during the follow-up period, and the 1-, 3- and 5-year survival rate were 87.7%, 74.5% and 55.9% respectively. Cox regression analysis showed that interstitial pneumonia (RR=12.119, P=0.001), heart disease (RR=2.935, P=0.020) and tumor (RR=3.735, P=0.048) were the unfavorable factors of death, while long-term hormones (RR=0.329, P=0.024) and persistent immunosuppressant therapy (RR=0.148, P=0.022) were protective factors. Conclusion The five-year survival rate of patients with PM/DM is still low, and pulmonary interstitial disease, tumor, cardiac involvement, and pulmonary infection are the major dead causes, while long-team immunosuppression and hormone therapy can decrease the PM/DM mortality.

Citation： DONGJian-ling, ZOUJin-mei, ZHANGYu, TIANLan, YANGJing. The Survival Rate and Death Cause Analysis of Patients with Polymyositis and Dermatomyositis. West China Medical Journal, 2014, 29(4): 702-705. doi: 10.7507/1002-0179.20140210 Copy

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6.	王红, 丁丛珠, 张华勇, 等. 64例多发性肌炎/皮肌炎的预后及死亡因素的相关分析[J]. 南京医科大学学报·自然科学版, 2009(4):527-529.
7.	Woo JH, Kim YJ, Kim JJ, et al. Mortality factors in idiopathic inflammatory myopathy:focusing on malignancy and interstitial lung disease[J]. Mod Rheumatol, 2013, 23(3):503-508.
8.	Murakami Y, Kanazawa K, Okuno K, et al. High-grade neuroendocrine carcinoma of the lung presenting an unusual spread mimicking pleural mesothelioma associated with dermatomyositis[J]. Am J Med Sci, 2004, 327(4):227-230.
9.	Chen YJ, Wu CY, Huang YL, et al. Cancers risks of dermatommyositis and polyostis:a nationwide cohort study in Taiwan[J]. Arthritis Res Ther, 2010, 12(2):70.
10.	陈晔, 王国春. 特发性炎性肌病与肿瘤的关联性研究进展[J]. 中华风湿病学杂志, 2008, 12(7):493-495.
11.	Ungprasert P, Leeaphorn N, Hosiriluck N, et al. Clinical features of inflammatory myopathies and their association with malignancy:a systematic review in Asian population[J/OL]. ISRN Rheumatol, 2013. http://dx.doi.org/10.1155/2013/509354.
12.	Meyer O, Hayem G, Palazzo E, et al. Interstitial lung disease due to polymyositis or dermatomyositis:effect of a 6-month course of i.v.pulse cyclophosphamide[J]. Clin Exp Rheumatol, 2005, 23(5):724.
13.	高惠英, 温鸿雁, 李小峰, 等. 多发性肌炎/皮肌炎合并肺间质病变的临床特征和预后[J]. 中华风湿病学杂志, 2009, 13(8):554-556.
14.	Chen IJ, Tsai WP, Wu YJ, et al. Infections in polymyositis and dermatomyositis:analysis of 192 cases[J]. Rheumatology (Oxford), 2010, 49(12):2429-2437.
15.	Gupta R, Wayangankar SA, Targoff IN, et al. Clinical cardiac involvement in idiopathic inflammatory myopathies:a systematic review[J]. Int J Cardiol, 2011, 148(3):261-270.

1. Bohan A, Peter JB. Polumyositis and dermatomyositis[J]. N Engl J Med, 1975, 292:344-347.
2. 蒋明. 中华风湿病学[M]. 北京:华夏出版社, 2004:1192.
3. Yu KH, Wu YJ, Kuo CF, et al. Survival analysis of patients with dermatomyositis and polymyositis:analysis of 192 Chinese cases[J]. Clin Rheumatol, 2011, 30(12):1595-1601.
4. Marie I. Morbidity and mortality in adult polymyositis and dermatomyositis[J]. Curr Rheumatol Rep, 2012, 14(3):275-285.
5. Buchbinder R, Hill CL. Malignancy in patients with inflammatory myopathy[J]. Curr Rheumatol Rep, 2002, 4(5):415-426.
6. 王红, 丁丛珠, 张华勇, 等. 64例多发性肌炎/皮肌炎的预后及死亡因素的相关分析[J]. 南京医科大学学报·自然科学版, 2009(4):527-529.
7. Woo JH, Kim YJ, Kim JJ, et al. Mortality factors in idiopathic inflammatory myopathy:focusing on malignancy and interstitial lung disease[J]. Mod Rheumatol, 2013, 23(3):503-508.
8. Murakami Y, Kanazawa K, Okuno K, et al. High-grade neuroendocrine carcinoma of the lung presenting an unusual spread mimicking pleural mesothelioma associated with dermatomyositis[J]. Am J Med Sci, 2004, 327(4):227-230.
9. Chen YJ, Wu CY, Huang YL, et al. Cancers risks of dermatommyositis and polyostis:a nationwide cohort study in Taiwan[J]. Arthritis Res Ther, 2010, 12(2):70.
10. 陈晔, 王国春. 特发性炎性肌病与肿瘤的关联性研究进展[J]. 中华风湿病学杂志, 2008, 12(7):493-495.
11. Ungprasert P, Leeaphorn N, Hosiriluck N, et al. Clinical features of inflammatory myopathies and their association with malignancy:a systematic review in Asian population[J/OL]. ISRN Rheumatol, 2013. http://dx.doi.org/10.1155/2013/509354.
12. Meyer O, Hayem G, Palazzo E, et al. Interstitial lung disease due to polymyositis or dermatomyositis:effect of a 6-month course of i.v.pulse cyclophosphamide[J]. Clin Exp Rheumatol, 2005, 23(5):724.
13. 高惠英, 温鸿雁, 李小峰, 等. 多发性肌炎/皮肌炎合并肺间质病变的临床特征和预后[J]. 中华风湿病学杂志, 2009, 13(8):554-556.
14. Chen IJ, Tsai WP, Wu YJ, et al. Infections in polymyositis and dermatomyositis:analysis of 192 cases[J]. Rheumatology (Oxford), 2010, 49(12):2429-2437.
15. Gupta R, Wayangankar SA, Targoff IN, et al. Clinical cardiac involvement in idiopathic inflammatory myopathies:a systematic review[J]. Int J Cardiol, 2011, 148(3):261-270.

West China Medical Journal

The Survival Rate and Death Cause Analysis of Patients with Polymyositis and Dermatomyositis

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