Disease-related nutritional risk and mortality in systemic sclerosis

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

To evaluate the relationship between mortality and nutritional risk associated with disease activity in Systemic Sclerosis (SSc). Methods: A single-centre prospective cohort study involving 160 SSc outpatients (median age, 62 years [25th-75th, 54-68]). Nutritional risk was assessed by the Malnutrition Universal Screening Tool (MUST), a screening tool that combines anthropometric parameters of nutritional status (body mass index [BMI] and percentage of unintentional weight loss [WL]) with the presence of an "acute disease" (as defined by a disease activity score ≥3 according to Valentini's criteria). Results: Prevalence of high nutritional risk (MUST score 2) was 24.4% [95%CI, 17.4-31.3]. A low nutritional risk (MUST=1) was detected in 30% of our study sample. In hazard analysis (median follow-up duration=46 months [25th-75th percentile, 31-54]), high nutritional risk was significantly associated with mortality (HR=8.3 [95%CI, 2.1-32.1]). The performance of the model based on nutritional risk including disease activity (Harrell's c=0.74 [95%CI, 0.59-0.89]) was superior to that based on active disease alone (HR=6.3 [95%CI, 1.8-21.7]; Harrell's c=0.68 [95%CI, 0.53-0.84]). Risk scored only by anthropometric parameters (prevalence, 9.4% [95%CI, 4.6-14.2]) was not associated with mortality: HR=2.8 [95%CI, 0.6-13.2]. Conclusions: In SSc outpatients MUST significantly predicts mortality. The combined assessment of nutritional parameters and disease activity significantly improves the evaluation of mortality risk. Disease-related nutritional risk screening should be systematically included in the clinical workup of every SSc patient.

Original languageEnglish
Pages (from-to)558-561
Number of pages4
JournalClinical Nutrition
Volume33
Issue number3
DOIs
Publication statusPublished - 2014

Fingerprint

Systemic Scleroderma
Mortality
Malnutrition
Outpatients
Nutrition Assessment
Acute Disease
Nutritional Status
Weight Loss
Body Mass Index
Cohort Studies
Prospective Studies

Keywords

  • Disease activity
  • Mortality
  • Nutritional risk
  • Systemic sclerosis

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine
  • Nutrition and Dietetics
  • Medicine(all)

Cite this

Disease-related nutritional risk and mortality in systemic sclerosis. / Cereda, Emanuele; Codullo, Veronica; Klersy, Catherine; Breda, Silvia; Crippa, Anna; Rava, Maria Luisa; Orlandi, Margherita; Bonardi, Chiara; Fiorentini, Maria Lina; Caporali, Roberto; Caccialanza, Riccardo.

In: Clinical Nutrition, Vol. 33, No. 3, 2014, p. 558-561.

Research output: Contribution to journalArticle

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title = "Disease-related nutritional risk and mortality in systemic sclerosis",
abstract = "To evaluate the relationship between mortality and nutritional risk associated with disease activity in Systemic Sclerosis (SSc). Methods: A single-centre prospective cohort study involving 160 SSc outpatients (median age, 62 years [25th-75th, 54-68]). Nutritional risk was assessed by the Malnutrition Universal Screening Tool (MUST), a screening tool that combines anthropometric parameters of nutritional status (body mass index [BMI] and percentage of unintentional weight loss [WL]) with the presence of an {"}acute disease{"} (as defined by a disease activity score ≥3 according to Valentini's criteria). Results: Prevalence of high nutritional risk (MUST score 2) was 24.4{\%} [95{\%}CI, 17.4-31.3]. A low nutritional risk (MUST=1) was detected in 30{\%} of our study sample. In hazard analysis (median follow-up duration=46 months [25th-75th percentile, 31-54]), high nutritional risk was significantly associated with mortality (HR=8.3 [95{\%}CI, 2.1-32.1]). The performance of the model based on nutritional risk including disease activity (Harrell's c=0.74 [95{\%}CI, 0.59-0.89]) was superior to that based on active disease alone (HR=6.3 [95{\%}CI, 1.8-21.7]; Harrell's c=0.68 [95{\%}CI, 0.53-0.84]). Risk scored only by anthropometric parameters (prevalence, 9.4{\%} [95{\%}CI, 4.6-14.2]) was not associated with mortality: HR=2.8 [95{\%}CI, 0.6-13.2]. Conclusions: In SSc outpatients MUST significantly predicts mortality. The combined assessment of nutritional parameters and disease activity significantly improves the evaluation of mortality risk. Disease-related nutritional risk screening should be systematically included in the clinical workup of every SSc patient.",
keywords = "Disease activity, Mortality, Nutritional risk, Systemic sclerosis",
author = "Emanuele Cereda and Veronica Codullo and Catherine Klersy and Silvia Breda and Anna Crippa and Rava, {Maria Luisa} and Margherita Orlandi and Chiara Bonardi and Fiorentini, {Maria Lina} and Roberto Caporali and Riccardo Caccialanza",
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AU - Cereda, Emanuele

AU - Codullo, Veronica

AU - Klersy, Catherine

AU - Breda, Silvia

AU - Crippa, Anna

AU - Rava, Maria Luisa

AU - Orlandi, Margherita

AU - Bonardi, Chiara

AU - Fiorentini, Maria Lina

AU - Caporali, Roberto

AU - Caccialanza, Riccardo

PY - 2014

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N2 - To evaluate the relationship between mortality and nutritional risk associated with disease activity in Systemic Sclerosis (SSc). Methods: A single-centre prospective cohort study involving 160 SSc outpatients (median age, 62 years [25th-75th, 54-68]). Nutritional risk was assessed by the Malnutrition Universal Screening Tool (MUST), a screening tool that combines anthropometric parameters of nutritional status (body mass index [BMI] and percentage of unintentional weight loss [WL]) with the presence of an "acute disease" (as defined by a disease activity score ≥3 according to Valentini's criteria). Results: Prevalence of high nutritional risk (MUST score 2) was 24.4% [95%CI, 17.4-31.3]. A low nutritional risk (MUST=1) was detected in 30% of our study sample. In hazard analysis (median follow-up duration=46 months [25th-75th percentile, 31-54]), high nutritional risk was significantly associated with mortality (HR=8.3 [95%CI, 2.1-32.1]). The performance of the model based on nutritional risk including disease activity (Harrell's c=0.74 [95%CI, 0.59-0.89]) was superior to that based on active disease alone (HR=6.3 [95%CI, 1.8-21.7]; Harrell's c=0.68 [95%CI, 0.53-0.84]). Risk scored only by anthropometric parameters (prevalence, 9.4% [95%CI, 4.6-14.2]) was not associated with mortality: HR=2.8 [95%CI, 0.6-13.2]. Conclusions: In SSc outpatients MUST significantly predicts mortality. The combined assessment of nutritional parameters and disease activity significantly improves the evaluation of mortality risk. Disease-related nutritional risk screening should be systematically included in the clinical workup of every SSc patient.

AB - To evaluate the relationship between mortality and nutritional risk associated with disease activity in Systemic Sclerosis (SSc). Methods: A single-centre prospective cohort study involving 160 SSc outpatients (median age, 62 years [25th-75th, 54-68]). Nutritional risk was assessed by the Malnutrition Universal Screening Tool (MUST), a screening tool that combines anthropometric parameters of nutritional status (body mass index [BMI] and percentage of unintentional weight loss [WL]) with the presence of an "acute disease" (as defined by a disease activity score ≥3 according to Valentini's criteria). Results: Prevalence of high nutritional risk (MUST score 2) was 24.4% [95%CI, 17.4-31.3]. A low nutritional risk (MUST=1) was detected in 30% of our study sample. In hazard analysis (median follow-up duration=46 months [25th-75th percentile, 31-54]), high nutritional risk was significantly associated with mortality (HR=8.3 [95%CI, 2.1-32.1]). The performance of the model based on nutritional risk including disease activity (Harrell's c=0.74 [95%CI, 0.59-0.89]) was superior to that based on active disease alone (HR=6.3 [95%CI, 1.8-21.7]; Harrell's c=0.68 [95%CI, 0.53-0.84]). Risk scored only by anthropometric parameters (prevalence, 9.4% [95%CI, 4.6-14.2]) was not associated with mortality: HR=2.8 [95%CI, 0.6-13.2]. Conclusions: In SSc outpatients MUST significantly predicts mortality. The combined assessment of nutritional parameters and disease activity significantly improves the evaluation of mortality risk. Disease-related nutritional risk screening should be systematically included in the clinical workup of every SSc patient.

KW - Disease activity

KW - Mortality

KW - Nutritional risk

KW - Systemic sclerosis

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