{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T05:07:04Z","timestamp":1784696824083,"version":"3.55.0"},"reference-count":26,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T00:00:00Z","timestamp":1784678400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Mortality in antineutrophil cytoplasmic antibody-associated vasculitis (AAV) is influenced by active inflammation, organ-threatening severity, irreversible damage and host vulnerability. We evaluated how BVAS-2003, FFS-2009 and VDI relate to all-cause mortality, and compared their endpoint discrimination with a baseline cardio-renal vulnerability model informed by the DANGER framework.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively studied 122 patients with AAV from two tertiary rheumatology centers. BVAS-2003 and FFS-2009 were assessed at diagnosis. VDI was updated during follow-up and was interpreted as accumulated damage burden rather than as a time-fixed baseline predictor. Overall survival was estimated using Kaplan\u2013Meier analysis. Endpoint associations were assessed using a parsimonious multivariable logistic model, and discrimination was compared using receiver operating characteristic curves.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>During a median follow-up of 36\u202fmonths, 36 patients died. Estimated 1-, 3- and 5-year survival rates were 78, 58 and 39%, respectively. Non-survivors had higher BVAS-2003, higher FFS-2009, higher accumulated VDI, lower hemoglobin, higher serum creatinine and more frequent dialysis. In the endpoint multivariable model, FFS-2009 and VDI retained associations with all-cause mortality, whereas BVAS-2003 did not retain an independent association after adjustment. The DANGER-variable model showed numerically highest discrimination (area under the curve 0.78), followed by VDI (0.74), FFS-2009 (0.73) and BVAS-2003 (0.71).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this severe real-world AAV cohort, mortality stratification was associated with baseline organ-threatening severity, endpoint accumulated damage burden and cardio-renal vulnerability more than with global activity alone. Because VDI was not measured at a uniform landmark, VDI-related findings should be interpreted as endpoint damage-burden associations rather than validated prospective prediction.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1909872","type":"journal-article","created":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T04:46:36Z","timestamp":1784695596000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Mortality risk stratification in antineutrophil cytoplasmic antibody-associated vasculitis: baseline severity, accumulated damage burden and cardio-renal vulnerability in a Chinese two-center cohort"],"prefix":"10.3389","volume":"13","author":[{"given":"Lina","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Rheumatology and Immunology, Peking University International Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Immunology, Peking University International Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Penghui","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Immunology, The Fourth Medical Center of PLA General Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheng-Guang","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Immunology, Peking University International Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huiqiong","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Immunology, The Fourth Medical Center of PLA General Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,22]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1036","DOI":"10.1136\/ard.2009.109389","article-title":"Early mortality in systemic vasculitis: relative contribution of adverse events and active vasculitis","volume":"69","author":"Little","year":"2010","journal-title":"Ann Rheum Dis"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"71","DOI":"10.1038\/s41572-020-0204-y","article-title":"ANCA-associated vasculitis","volume":"6","author":"Kitching","year":"2020","journal-title":"Nat Rev Dis Primers"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"488","DOI":"10.1136\/ard.2010.137778","article-title":"Long-term patient survival in ANCA-associated vasculitis","volume":"70","author":"Flossmann","year":"2011","journal-title":"Ann Rheum 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