{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T13:00:40Z","timestamp":1787317240751,"version":"build-2736575974"},"reference-count":35,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2023,8,19]],"date-time":"2023-08-19T00:00:00Z","timestamp":1692403200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100001003","name":"Boehringer Ingelheim","doi-asserted-by":"publisher","award":["This work was supported by Boehringer Ingelheim A\/"],"award-info":[{"award-number":["This work was supported by Boehringer Ingelheim A\/"]}],"id":[{"id":"10.13039\/100001003","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Chron Respir Dis"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This population-based, matched cohort study evaluates the impact of comorbidities on mortality among systemic sclerosis (SSc) patients with and without interstitial lung disease (ILD).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>Patients with a first-time SSc diagnosis between 2002 and 2015 were identified in the Danish National Patient Registry, separated into two cohorts \u2013 with ILD (SSc-ILD) and without ILD (non-ILD SSc), and matched 1:4 with controls from the general population on age, sex, residency and marital status. Comorbidity and mortality data were obtained from national registries. The Deyo-Charlson comorbidity score (DCcs) was used for assessment of the burden of comorbidities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>1732 patients with SSc and 6919 controls were included; 258 (14.9%) patients had SSc-ILD. The hazard ratio (HR) for death was 2.8 (95% CI 2.4\u20133.3) in SSc, and especially increased in SSc-ILD (HR 4.2 (95% CI 3.2\u20135.4)), males (HR 3.1 95% CI 2.4\u20134.1) and younger adults (aged 18\u201340 (HR 6.9, 95% CI 3.4\u201314.2) and 41\u201350 (HR 7.7, 95% CI 3.8\u201315.6)). In non-ILD SSc, mortality increased with increasing DCcs. Cancer was the most frequent cause of death in SSc (24.9% of deaths) and in controls (33.5%), in SSc followed by musculoskeletal and connective tissue diseases (22.7%); the cause of only 0.8% of deaths among controls.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The high prevalence of comorbidities in SSc had extensive impact on mortality. Mortality was increased in males, in young adults and in SSc-ILD, underlining the excess mortality associated with ILD. These findings emphasise the importance of timely diagnosis and optimal management of organ involvement and comorbidities in SSc.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/14799731231195041","type":"journal-article","created":{"date-parts":[[2023,8,19]],"date-time":"2023-08-19T09:46:38Z","timestamp":1692438398000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Comorbidity and mortality in systemic sclerosis and matched controls: Impact of interstitial lung disease. A population based cohort study based on health registry data"],"prefix":"10.1177","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2398-9096","authenticated-orcid":false,"given":"Malene","family":"Knarborg","sequence":"first","affiliation":[{"name":"Department of Medicine, Lillebaelt Hospital, Vejle, Denmark"},{"name":"Department of Regional Health Research, University of Southern Denmark, Odense, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6353-8671","authenticated-orcid":false,"given":"Charlotte","family":"Hyldgaard","sequence":"additional","affiliation":[{"name":"Diagnostic Centre, University Research Clinic for Innovative Patient Pathways, Silkeborg Regional Hospital, Silkeborg, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabeth","family":"Bendstrup","sequence":"additional","affiliation":[{"name":"Center for Rare Lung Diseases, Department of Respiratory Diseases and Allergy, Aarhus University Hospital, Aarhus, Denmark"},{"name":"Department of Clinical Medicine, Aarhus University, Aarhus, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jesper R\u00f8mhild","family":"Davidsen","sequence":"additional","affiliation":[{"name":"South Danish Center for Interstitial Lung Diseases (SCILS), Department of Respiratory Medicine, Odense University Hospital, Odense, Denmark"},{"name":"Odense Respiratory Research Unit (ODIN), Department of Clinical Research, University of Southern Denmark, Odense, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anders","family":"L\u00f8kke","sequence":"additional","affiliation":[{"name":"Department of Medicine, Lillebaelt Hospital, Vejle, Denmark"},{"name":"Department of Regional Health Research, University of Southern Denmark, Odense, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saher Burhan","family":"Shaker","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Herlev and Gentofte University Hospital, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3075-3463","authenticated-orcid":false,"given":"Ole","family":"Hilberg","sequence":"additional","affiliation":[{"name":"Department of Medicine, Lillebaelt Hospital, Vejle, Denmark"},{"name":"Department of Regional Health Research, University of Southern Denmark, Odense, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2023,8,19]]},"reference":[{"key":"bibr1-14799731231195041","doi-asserted-by":"publisher","DOI":"10.1002\/art.38098"},{"issue":"1194","key":"bibr2-14799731231195041","first-page":"3","volume":"37","author":"Barsotti S","year":"2019","journal-title":"Clin Exp Rheumatol"},{"key":"bibr3-14799731231195041","doi-asserted-by":"publisher","DOI":"10.1007\/s00281-015-0551-z"},{"key":"bibr4-14799731231195041","doi-asserted-by":"crossref","unstructured":"Li Q, Wallace L, Patnaik P, et al. 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