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Assessment of diagnostic delay, morbidity, and mortality outcomes in 302 calciphylaxis patients over a 17-year period: A retrospective cohort study.
Tan, Alice J; Xia, Joyce; Glennon, Colleen M; Locascio, Joseph J; Gabel, Colleen K; Nguyen, Emily D; Chand, Sidharth; Rrapi, Renajd; Dobry, Allison S; Garza-Mayers, Anna Cristina; Ko, Lauren N; Shah, Radhika; St John, Jessica; Nigwekar, Sagar U; Kroshinsky, Daniela.
Afiliación
  • Tan AJ; Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts.
  • Xia J; Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts.
  • Glennon CM; Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts.
  • Locascio JJ; Department of Neurology, Harvard Catalyst Biostatistics, Massachusetts General Hospital, Boston, Massachusetts.
  • Gabel CK; Department of Dermatology, University of Massachusetts Medical School, Worcester, Massachusetts.
  • Nguyen ED; Department of Dermatology, University of Colorado School of Medicine, Aurora, Colorado.
  • Chand S; Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts.
  • Rrapi R; Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts.
  • Dobry AS; Department of Dermatology, University of California, San Francisco School of Medicine, San Francisco, California.
  • Garza-Mayers AC; Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts.
  • Ko LN; Department of Dermatology, Brigham and Women's Hospital, Boston, Massachusetts.
  • Shah R; Department of Dermatology, Robert Wood Johnson Medical School, New Brunswick, New Jersey.
  • St John J; Department of Dermatology, University of Massachusetts Medical School, Worcester, Massachusetts.
  • Nigwekar SU; Department of Nephrology, Massachusetts General Hospital, Boston, Massachusetts.
  • Kroshinsky D; Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts; Department of Dermatology, Duke University Medical Center, Durham, North Carolina. Electronic address: dkroshinsky@mgh.harvard.edu.
J Am Acad Dermatol ; 91(5): 834-842, 2024 Nov.
Article en En | MEDLINE | ID: mdl-38972479
ABSTRACT

BACKGROUND:

Calciphylaxis patients historically have experienced diagnostic challenges and high morbidity; however limited data is available examining these characteristics over time.

OBJECTIVE:

The primary goals were to a) investigate factors associated with diagnostic delay of calciphylaxis and b) assess morbidity outcomes. The secondary goal was to provide updated mortality rates.

METHODS:

A retrospective review of 302 adult patients diagnosed with calciphylaxis between January 1, 2006 and December 31, 2022 was conducted. Univariate and multivariate statistical analyses were performed.

RESULTS:

Nonnephrogenic calciphylaxis (P = .0004) and involvement of the fingers (P = .0001) were significantly associated with an increased diagnostic delay, whereas involvement of the arms (P = .01) and genitalia (P = .022) resulted in fewer days to diagnosis. Almost all patients with genitalia, finger, or toe involvement had nephrogenic disease. The number of complications per patient decreased with time, especially for wound infections (P = .028), increase in lesion number (P = .012), and recurrent hospitalizations (P = .020). Updated 1-year mortality rates were 36.70% and 30.77% for nephrogenic and nonnephrogenic calciphylaxis, respectively.

LIMITATIONS:

Limitations include the retrospective nature and data from a single institution.

CONCLUSION:

Diagnostic delay, particularly in nonnephrogenic calciphylaxis, and complications per patient decreased with time, highlighting the importance of continued awareness to expedite diagnosis. Mortality rates have continued to improve in recent years.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Calcifilaxia / Diagnóstico Tardío Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: J Am Acad Dermatol Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Calcifilaxia / Diagnóstico Tardío Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: J Am Acad Dermatol Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos