{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T08:45:36Z","timestamp":1792226736405,"version":"4.4.0"},"reference-count":32,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2017,6,4]],"date-time":"2017-06-04T00:00:00Z","timestamp":1496534400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001537","name":"University of Auckland","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001537","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J of Rheum Dis"],"published-print":{"date-parts":[[2018,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To characterize the causes of mortality and standardised mortality ratio in a cohort of patients with systemic sclerosis (<jats:styled-content style=\"fixed-case\">SS<\/jats:styled-content>c).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A cohort of 132 patients enrolled at the Waikato Systemic Sclerosis Clinic was prospectively followed from 2005 to 2016. Patient demographics, diagnoses and laboratory reports were used to assess risk of mortality and generate standardised mortality ratios (<jats:styled-content style=\"fixed-case\">SMR<\/jats:styled-content>). Survival was analyzed using Kaplan\u2010Meier methods.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the cohort of 132 patients, 20 (15%) were deceased by the end of the study period. The median age of diagnosis and death was 52 years (range 13\u201386) and 71 years (range 42\u201387) respectively. Seventy percent of deaths were<jats:styled-content style=\"fixed-case\">SS<\/jats:styled-content>c related and the leading causes of death were due to pulmonary arterial hypertension (<jats:styled-content style=\"fixed-case\">PAH<\/jats:styled-content>), interstitial lung disease (<jats:styled-content style=\"fixed-case\">ILD<\/jats:styled-content>) and scleroderma renal crisis (<jats:styled-content style=\"fixed-case\">SRC<\/jats:styled-content>). Patients diagnosed after the age of 60 had renal or cardiac manifestations and were associated with a significantly increased risk of mortality. The overall<jats:styled-content style=\"fixed-case\">SMR<\/jats:styled-content>was 2.59 (95%<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>1.67\u20134.01) and was higher in those with diffuse versus limited<jats:styled-content style=\"fixed-case\">SS<\/jats:styled-content>c (6.46, 95%<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>3.08\u201313.54<jats:italic>vs<\/jats:italic>. 1.93, 95%<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>1.10\u20133.41) and males (4.17, 95%<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>1.74\u201310.02<jats:italic>vs<\/jats:italic>. 2.30, 95%<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>1.39\u20133.81).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study demonstrated an increased risk of mortality in patients with<jats:styled-content style=\"fixed-case\">SS<\/jats:styled-content>c relative to that of the general population. An excess in risk was observed particularly in those with diffuse<jats:styled-content style=\"fixed-case\">SS<\/jats:styled-content>c and in males. Renal and cardiac involvement were found to be significant indicators of mortality and reinforces the necessity of screening for these complications.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1756-185x.13111","type":"journal-article","created":{"date-parts":[[2017,6,5]],"date-time":"2017-06-05T04:47:17Z","timestamp":1496638037000},"page":"253-260","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Mortality in the Waikato Hospital Systemic Sclerosis Cohort"],"prefix":"10.1111","volume":"21","author":[{"given":"Clement","family":"Ooi","sequence":"first","affiliation":[{"name":"Waikato Clinical School University of Auckland Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2953-9064","authenticated-orcid":false,"given":"Kamal","family":"Solanki","sequence":"additional","affiliation":[{"name":"Waikato Clinical School University of Auckland Auckland New 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