In-hospital mortality in febrile lupus patients based on 2016 EULAR/ACR/PRINTO classification criteria for macrophage activation syndrome

Sung Soo Ahn, Byung Woo Yoo, Seung Min Jung, Sang Won Lee, YongBeom Park, Jason Jungsik Song

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Objective To evaluate the clinical significance of the 2016 European League Against Rheumatism (EULAR)/American College of Rheumatology (ACR)/Pediatric Rheumatology International Trials Organization (PRINTO) classification criteria for macrophage activation syndrome (MAS) in patients with febrile systemic lupus erythematosus (SLE). Methods We performed a retrospective analysis of SLE patients with fever, who were admitted to Severance Hospital between December 2005 and May 2016. Patients were evaluated for MAS using the 2016 classification criteria for MAS. Clinical features and laboratory findings were compared and overall survival rate was analyzed. Forward and backward stepwise logistic regression analysis was used to evaluate the factors associated with in-hospital mortality. Results Among 157 patients with SLE, 54 (34.3%) were considered to have MAS on admission (n = 42) and during admission (n = 12). For patients who already have MAS on admission, their baseline laboratory findings demonstrated lower CRP, platelets, total protein, albumin, complement C3, fibrinogen and higher AST, ALT, total bilirubin, ferritin, and triglyceride. The overall survival rate was significantly lower in patients with MAS than without MAS (64.8% vs. 97.0%, p < 0.001). Multivariate analysis showed that the presence of MAS was significantly associated with in-hospital mortality in febrile SLE patients (OR = 64.5; 95% CI: 7.6–544.4; p < 0.001). Conclusions The 2016 classification criteria for MAS is useful to identify febrile SLE patients at high risk for in-hospital mortality. Monitoring febrile SLE patients with the new 2016 classification criteria might aid in the early detection of MAS.

Original languageEnglish
Pages (from-to)216-221
Number of pages6
JournalSeminars in Arthritis and Rheumatism
Volume47
Issue number2
DOIs
Publication statusPublished - 2017 Oct 1

Fingerprint

Macrophage Activation Syndrome
Rheumatology
Hospital Mortality
Rheumatic Diseases
Fever
Organizations
Pediatrics
Systemic Lupus Erythematosus
Survival Rate
Complement C3
Ferritins
Bilirubin
Fibrinogen
Albumins
Triglycerides

All Science Journal Classification (ASJC) codes

  • Rheumatology
  • Anesthesiology and Pain Medicine

Cite this

Ahn, Sung Soo ; Yoo, Byung Woo ; Jung, Seung Min ; Lee, Sang Won ; Park, YongBeom ; Song, Jason Jungsik. / In-hospital mortality in febrile lupus patients based on 2016 EULAR/ACR/PRINTO classification criteria for macrophage activation syndrome. In: Seminars in Arthritis and Rheumatism. 2017 ; Vol. 47, No. 2. pp. 216-221.
@article{467968b7a823492db23ecd8c10f8110a,
title = "In-hospital mortality in febrile lupus patients based on 2016 EULAR/ACR/PRINTO classification criteria for macrophage activation syndrome",
abstract = "Objective To evaluate the clinical significance of the 2016 European League Against Rheumatism (EULAR)/American College of Rheumatology (ACR)/Pediatric Rheumatology International Trials Organization (PRINTO) classification criteria for macrophage activation syndrome (MAS) in patients with febrile systemic lupus erythematosus (SLE). Methods We performed a retrospective analysis of SLE patients with fever, who were admitted to Severance Hospital between December 2005 and May 2016. Patients were evaluated for MAS using the 2016 classification criteria for MAS. Clinical features and laboratory findings were compared and overall survival rate was analyzed. Forward and backward stepwise logistic regression analysis was used to evaluate the factors associated with in-hospital mortality. Results Among 157 patients with SLE, 54 (34.3{\%}) were considered to have MAS on admission (n = 42) and during admission (n = 12). For patients who already have MAS on admission, their baseline laboratory findings demonstrated lower CRP, platelets, total protein, albumin, complement C3, fibrinogen and higher AST, ALT, total bilirubin, ferritin, and triglyceride. The overall survival rate was significantly lower in patients with MAS than without MAS (64.8{\%} vs. 97.0{\%}, p < 0.001). Multivariate analysis showed that the presence of MAS was significantly associated with in-hospital mortality in febrile SLE patients (OR = 64.5; 95{\%} CI: 7.6–544.4; p < 0.001). Conclusions The 2016 classification criteria for MAS is useful to identify febrile SLE patients at high risk for in-hospital mortality. Monitoring febrile SLE patients with the new 2016 classification criteria might aid in the early detection of MAS.",
author = "Ahn, {Sung Soo} and Yoo, {Byung Woo} and Jung, {Seung Min} and Lee, {Sang Won} and YongBeom Park and Song, {Jason Jungsik}",
year = "2017",
month = "10",
day = "1",
doi = "10.1016/j.semarthrit.2017.02.002",
language = "English",
volume = "47",
pages = "216--221",
journal = "Seminars in Arthritis and Rheumatism",
issn = "0049-0172",
publisher = "W.B. Saunders Ltd",
number = "2",

}

In-hospital mortality in febrile lupus patients based on 2016 EULAR/ACR/PRINTO classification criteria for macrophage activation syndrome. / Ahn, Sung Soo; Yoo, Byung Woo; Jung, Seung Min; Lee, Sang Won; Park, YongBeom; Song, Jason Jungsik.

In: Seminars in Arthritis and Rheumatism, Vol. 47, No. 2, 01.10.2017, p. 216-221.

Research output: Contribution to journalArticle

TY - JOUR

T1 - In-hospital mortality in febrile lupus patients based on 2016 EULAR/ACR/PRINTO classification criteria for macrophage activation syndrome

AU - Ahn, Sung Soo

AU - Yoo, Byung Woo

AU - Jung, Seung Min

AU - Lee, Sang Won

AU - Park, YongBeom

AU - Song, Jason Jungsik

PY - 2017/10/1

Y1 - 2017/10/1

N2 - Objective To evaluate the clinical significance of the 2016 European League Against Rheumatism (EULAR)/American College of Rheumatology (ACR)/Pediatric Rheumatology International Trials Organization (PRINTO) classification criteria for macrophage activation syndrome (MAS) in patients with febrile systemic lupus erythematosus (SLE). Methods We performed a retrospective analysis of SLE patients with fever, who were admitted to Severance Hospital between December 2005 and May 2016. Patients were evaluated for MAS using the 2016 classification criteria for MAS. Clinical features and laboratory findings were compared and overall survival rate was analyzed. Forward and backward stepwise logistic regression analysis was used to evaluate the factors associated with in-hospital mortality. Results Among 157 patients with SLE, 54 (34.3%) were considered to have MAS on admission (n = 42) and during admission (n = 12). For patients who already have MAS on admission, their baseline laboratory findings demonstrated lower CRP, platelets, total protein, albumin, complement C3, fibrinogen and higher AST, ALT, total bilirubin, ferritin, and triglyceride. The overall survival rate was significantly lower in patients with MAS than without MAS (64.8% vs. 97.0%, p < 0.001). Multivariate analysis showed that the presence of MAS was significantly associated with in-hospital mortality in febrile SLE patients (OR = 64.5; 95% CI: 7.6–544.4; p < 0.001). Conclusions The 2016 classification criteria for MAS is useful to identify febrile SLE patients at high risk for in-hospital mortality. Monitoring febrile SLE patients with the new 2016 classification criteria might aid in the early detection of MAS.

AB - Objective To evaluate the clinical significance of the 2016 European League Against Rheumatism (EULAR)/American College of Rheumatology (ACR)/Pediatric Rheumatology International Trials Organization (PRINTO) classification criteria for macrophage activation syndrome (MAS) in patients with febrile systemic lupus erythematosus (SLE). Methods We performed a retrospective analysis of SLE patients with fever, who were admitted to Severance Hospital between December 2005 and May 2016. Patients were evaluated for MAS using the 2016 classification criteria for MAS. Clinical features and laboratory findings were compared and overall survival rate was analyzed. Forward and backward stepwise logistic regression analysis was used to evaluate the factors associated with in-hospital mortality. Results Among 157 patients with SLE, 54 (34.3%) were considered to have MAS on admission (n = 42) and during admission (n = 12). For patients who already have MAS on admission, their baseline laboratory findings demonstrated lower CRP, platelets, total protein, albumin, complement C3, fibrinogen and higher AST, ALT, total bilirubin, ferritin, and triglyceride. The overall survival rate was significantly lower in patients with MAS than without MAS (64.8% vs. 97.0%, p < 0.001). Multivariate analysis showed that the presence of MAS was significantly associated with in-hospital mortality in febrile SLE patients (OR = 64.5; 95% CI: 7.6–544.4; p < 0.001). Conclusions The 2016 classification criteria for MAS is useful to identify febrile SLE patients at high risk for in-hospital mortality. Monitoring febrile SLE patients with the new 2016 classification criteria might aid in the early detection of MAS.

UR - http://www.scopus.com/inward/record.url?scp=85014272190&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85014272190&partnerID=8YFLogxK

U2 - 10.1016/j.semarthrit.2017.02.002

DO - 10.1016/j.semarthrit.2017.02.002

M3 - Article

C2 - 28268026

AN - SCOPUS:85014272190

VL - 47

SP - 216

EP - 221

JO - Seminars in Arthritis and Rheumatism

JF - Seminars in Arthritis and Rheumatism

SN - 0049-0172

IS - 2

ER -