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Increased risk of mortality in systemic sclerosis‐associated digital ulcers: a systematic review and meta‐analysis
Author(s) -
Meunier P.,
Dequidt L.,
Barnetche T.,
Lazaro E.,
Duffau P.,
Richez C.,
Couzi L.,
Truchetet M.E.,
Seneschal J.
Publication year - 2019
Publication title -
journal of the european academy of dermatology and venereology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.655
H-Index - 107
eISSN - 1468-3083
pISSN - 0926-9959
DOI - 10.1111/jdv.15114
Subject(s) - medicine , meta analysis , relative risk , medline , intensive care medicine , confidence interval , political science , law
Background Survival can be threatened in certain forms of systemic sclerosis ( SS c) so clear prognostic factors are needed. Objectives The aim of this meta‐analysis was to assess the association between the presence of digital ulcers ( DU s) and mortality in SS c. Methods We performed a systematic review and meta‐analysis in the Pubmed and Scopus databases from the earliest records to May 2017. Two research strategies were performed: « systemic sclerosis » and « digital ulcers » (strategy A); « systemic sclerosis » and « mortality » (strategy B). The primary outcome was the mortality associated with the presence of DU s in patients with SS c. Results The literature search identified 1473 citations. Fifty‐nine studies were examined for full text. Ten articles were included for the meta‐analysis. SS c patients with DU s had an increased pooled mortality risk: RR = 1.53 ( IC 95%: [1.23–1.90]). Conclusions This meta‐analysis revealed a higher mortality in SS c patients with associated DU s. Having DU s may be a predictive factor of developing organ involvement such as pulmonary or cardiovascular events that could be associated with poor survival. It suggests that early screening of DU s in SS c patients is important to identify patients most at risk of poor survival.

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