Disease-related nutritional risk and mortality in systemic sclerosis

Emanuele Cereda, Veronica Codullo, Catherine Klersy, Silvia Breda, Anna Crippa, Maria Luisa Rava, Margherita Orlandi, Chiara Bonardi, Maria Lina Fiorentini, Roberto Caporali, Riccardo Caccialanza

Research output: Contribution to journalArticlepeer-review


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
Issue number3
Publication statusPublished - 2014


  • Disease activity
  • Mortality
  • Nutritional risk
  • Systemic sclerosis

ASJC Scopus subject areas

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


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