Infection Cited in Deaths of Hospitalized Patients With ANCA Vasculitis

The overall mortality rate of hospitalized patients with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis at a single academic medical center was 17% at 28 days after discharge, according to a study published the Journal of Clinical Rheumatology.

The finding stems from a medical record review of hospitalizations between October 2015 and December 2018 involving adults with granulomatosis with polyangiitis or microscopic polyangiitis. The study, conducted by a research team from Duke University, Durham, North Carolina, focused on hospital mortality rates, as well as causes and outcomes of hospitalization.

“Characterization of outcomes in ANCA–associated vasculitis can improve patient care and prognostication following hospitalization,” wrote corresponding author Catherine Sims, MD, of the Duke University Division of Rheumatology & Immunology, and study coauthors.

The review identified 54 patients with a total 127 hospitalizations during the study period. Active vasculitis was present in just a third of the 127 hospitalizations, according to the study. Fifteen patients with active vasculitis, among whom 10 had a new diagnosis, were admitted to the intensive care unit (ICU).

“Of 84 hospitalizations when vasculitis was inactive, infection was diagnosed in 31 admissions (36.9%), with inactive disease representing 44% of all ICU admissions,” researchers reported.

Overall mortality among hospitalized patients was 7%. Among patients admitted to the ICU, the mortality rate was 15%, the study found. Within 28 days of hospital discharge, an additional 5 patients died, bringing the overall mortality rate to 17%.

Infection was involved in all 4 hospital deaths and 3 of the 5 postdischarge deaths.

“Most hospitalizations and patient deaths were in the context of inactive vasculitis, with infection being the most common cause,” researchers concluded. “Infection and ICU admission were associated with patient death.”

Reference
Sims C, Golenbiewski J, Eudy AM, Allen NB, Clowse MEB. Hospital admissions and mortality in patients with anti-neutrophil cytoplasmic antibody-associated vasculitis. J Clin Rheumatol. 2023;29(6):e124-e129. doi:10.1097/RHU.0000000000001917