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Association of baseline non-severe anemia with clinical outcomes following the first recorded diagnosis of systemic sclerosis: A matched cohort study.

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Τίτλος: Association of baseline non-severe anemia with clinical outcomes following the first recorded diagnosis of systemic sclerosis: A matched cohort study.
Συγγραφείς: Lai YC; Department of Anesthesiology, Chi Mei Medical Center, Tainan, Taiwan., Weng HL; Department of Anesthesiology, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan., Hung KC; Department of Anesthesiology, Chi Mei Medical Center, Tainan, Taiwan.; School of Medicine, College of Medicine, National Sun Yat-sen University, Kaohsiung, Taiwan., Teng IC; Department of Anesthesiology, Chi Mei Medical Center, Tainan, Taiwan., Lan KM; Department of Anesthesiology, Chi Mei Hospital, Liouying, Tainan, Taiwan., Chen IW; Department of Anesthesiology, Chi Mei Hospital, Liouying, Tainan, Taiwan.
Πηγή: Medicine [Medicine (Baltimore)] 2026 Oct 16; Vol. 105 (42), pp. e51159.
Τύπος έκδοσης: Journal Article
Γλώσσα: English
Στοιχεία περιοδικού: Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 2985248R Publication Model: Print Cited Medium: Internet ISSN: 1536-5964 (Electronic) Linking ISSN: 00257974 NLM ISO Abbreviation: Medicine (Baltimore) Subsets: MEDLINE
Imprint Name(s): Original Publication: Hagerstown, Md : Lippincott Williams & Wilkins
Ιατρικοί όροι (MeSH): Scleroderma, Systemic*/mortality , Scleroderma, Systemic*/complications , Scleroderma, Systemic*/diagnosis , Anemia*/complications , Anemia*/epidemiology , Anemia*/mortality, Hemoglobins/analysis ; Humans ; Female ; Retrospective Studies ; Middle Aged ; Aged ; Prognosis ; Cohort Studies ; Proportional Hazards Models ; C-Reactive Protein ; Adult
Περίληψη: Systemic sclerosis (SSc) carries the highest mortality among systemic autoimmune diseases, yet the prognostic significance of anemia around the time of the first recorded SSc diagnosis is unclear. We examined whether baseline anemia is associated with early mortality and complications. This retrospective matched cohort study identified female adults with a first recorded SSc diagnosis between January 2010 and December 2024 from the TriNetX Research Network. Patients were required to have at least 5 years of pre-index observation without a documented SSc diagnosis. The network comprised 140 healthcare organizations, with approximately 70% of patients in the United States across all 9 census regions and 30% at international sites. Anemia was defined as hemoglobin (Hb) ≥8.0 and <12.0 g/dL and non-anemia as ≥12.0 g/dL, measured within ±30 days of diagnosis. For the Hb-stratified analysis, the anemia cohort was categorized as Hb ≥10.0 to <12.0 g/dL or ≥8.0 to <10.0 g/dL. One-to-one propensity score matching balanced baseline characteristics, and Cox proportional hazards models estimated hazard ratios (HRs) with 95% confidence intervals (CIs). The primary outcome was all-cause mortality during days 31 to 365 among patients surviving the 30-day landmark period; secondary outcomes were sepsis, acute kidney injury, intensive care unit admission, pulmonary fibrosis, and elevated C-reactive protein (≥10 mg/L). After matching, 5410 patients remained in each cohort. Baseline anemia was significantly associated with higher 1-year mortality (HR, 2.54; 95% CI, 1.99-3.22; P < .001) and with increased risks of sepsis (HR, 3.20; 95% CI, 2.38-4.30), acute kidney injury (HR, 2.24; 95% CI, 1.80-2.78), intensive care unit admission (HR, 1.92; 95% CI, 1.47-2.51), and elevated C-reactive protein (HR, 1.55; 95% CI, 1.37-1.74; all P < .001); no significant association was observed for pulmonary fibrosis (HR, 1.06; 95% CI, 0.96-1.17; P = .229). Associations persisted in sensitivity analyses and over 3-year follow-up. Mortality risk showed a graded pattern across Hb strata (Hb ≥10.0-<12.0 g/dL: HR, 1.66; Hb ≥8.0-<10.0 g/dL: HR, 3.33). Baseline anemia was associated with increased mortality and acute systemic complications following the first recorded SSc diagnosis; these observational findings warrant prospective validation.
(Copyright © 2026 the Author(s). Published by Wolters Kluwer Health, LLC.)
Competing Interests: The authors have no funding and conflicts of interest to declare.
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Contributed Indexing: Keywords: acute kidney injury; anemia; mortality; sepsis; systemic sclerosis
Substance Nomenclature: 0 (Hemoglobins)
9007-41-4 (C-Reactive Protein)
Entry Date(s): Date Created: 20261017 Date Completed: 20261017 Latest Revision: 20261017
Update Code: 20261017
DOI: 10.1097/MD.0000000000051159
PMID: 42888582
Βάση Δεδομένων: MEDLINE
Περιγραφή
ISSN:1536-5964
DOI:10.1097/MD.0000000000051159