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Mortality in patients with Sjögren Disease: A Prospective Cohort Study Identifying Key Predictors.

2025; The Journal of Rheumatology Publishing Company Limited; Linguagem: Inglês

10.3899/jrheum.2024-1033

1499-2752

Olga Rusinovich Lovgach, Zulema Plaza, M. Fernández Castro, José Rosas, Víctor M. Martínez‐Taboada, Alejandro Olivé, Raúl Menor Almagro, Belén Serrano Benavente, Judit Font Urgelles, Ángel García-Aparicio, Sara Manrique‐Arija, Alberto García-Vadillo, Ruth López‐González, Javier Narváez, Maͣ Beatriz Rodriguez-Lozano, C. Galisteo, Jorge Juan González Martín, Paloma Vela, C. Bohórquez Heras, Celia Erausquin, María Beatriz Paredes-Romero, Leyre Riancho‐Zarrabeitia, S. Melchor Díaz, José María Pego‐Reigosa, S. Heredia, C. Moriano, María Ángeles Blázquez-Cañamero, Paula Estrada Alarcón, Enrique Júdez, Joaquín Belzunegui Otaño, C. Ramos Giráldez, M Alvaro, Fernando Sánchez‐Alonso, José Luís Andreu,

Salivary Gland Disorders and Functions

To quantify the mortality risk in a large, well-characterized cohort of Sjögren's disease (SjD) patients and to identify independent predictors of mortality in this population. We included 314 patients diagnosed with SjD according to the 2002 American-European Consensus Group criteria from a prospective, multicenter SjögrenSER-PROS cohort. Detailed data on systemic manifestations, serological markers, disease activity, and mortality was collected after 9 years of follow up. The primary outcome was overall mortality, secondary analyses aimed to identify independent predictors of mortality using Cox proportional hazards models. Standardized mortality ratios were calculated by comparing the observed deaths in the SjD cohort to the expected deaths in an age- and sex-matched general population. The study identified a 70% increased mortality risk in the SjD cohort compared to the general population, with a standard mortality ratio (SMR) of 1.7. Infections (35.71%), malignancies (23.8%), and cardiovascular disease (7.14%) were the most common causes of death. Multivariate analysis revealed that older age (HR 1.11 per year, 95% CI 1.05-1.17), C4 hypocomplementemia (HR 3.75, 95% CI 1.52-9.24), elevated erythrocyte sedimentation rate (HR 1.01, 95% CI 1.00-1.03), history of heart failure (HR 4.24, 95% CI 1.89-9.51), and pulmonary involvement (HR 3.31, 95% CI 1.48-7.41) were independent predictors of mortality. This study shows a significantly increased mortality risk in SjD, with infections, malignancies, and cardiovascular disease as leading causes of death. Independent predictors of mortality include advanced age, C4 hypocomplementemia, elevated ESR, heart failure, and pulmonary involvement, underscoring the need for proactive, individualized management.