title: Changes in the pattern of death of 987 patients with systemic sclerosis from 1990 to 2009 from the nationwide Spanish Scleroderma Registry (RESCLE).
abstract: OBJECTIVE
  To determine the changes in the pattern of death of patients with systemic sclerosis (SSc) throughout 20 years.
  
  
  METHODS
  Data were collected from the Spanish Scleroderma Registry (RESCLE), retrospective multicentre database from 1990 to 2009. SSc-related and SSc-non related causes of death were assessed.
  
  
  RESULTS
  987 patients were recruited. Overall standardised mortality ratio (SMR) was 2.34 (2.24-2.44). SSc-related causes of death were responsible of 72% of all deaths of those patients diagnosed within 1990-99 vs. 48% within 2000-09 (p=0.006). Relative pulmonary death rate was stable over time (68.1% within 1990-99 vs. 63.9% within 2000-09, p=0.815). Relative renal death rate was decreasing over time (17% within 1990-99 vs. 5.5% within 2000-09, p=0.175). Heart distribution tripled its ratio (12.8% within 1990-99 vs. 30.6% within 2000-09, p=0.058).
  
  
  CONCLUSIONS
  SSc-related causes of death were decreasing over time and, among them, pulmonary involvement was the leading cause of death in both decades. The ratio of renal causes decreased since 1990 at the time that the ratio of cardiac causes increased.
authors.affiliation: Autoimmune Diseases Unit, Department of Internal Medicine, Bellvitge University Hospital-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain. mrubio@bellvitgehospital.cat.
authors.forename: Manuel
authors.initials: M
authors.lastname: Rubio-Rivas
authors.affiliation: Vall d'Hebron University Hospital, Department of Internal Medicine, Barcelona, Spain.
authors.forename: Carmen Pilar
authors.initials: CP
authors.lastname: Simeón-Aznar
authors.affiliation: Clinic Hospital, Department of Epidemiology Medicine, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain.
authors.forename: César
authors.initials: C
authors.lastname: Velasco
authors.affiliation: Department of Internal Medicine, Corporación Sanitaria Universitaria Parc Taulí, Sabadell, Barcelona, Spain.
authors.forename: Begoña
authors.initials: B
authors.lastname: Marí-Alfonso
authors.affiliation: Department of Autoimmune Diseases, Institut Clinic de Medicina i Dermatología, Hospital Clínic, Barcelona, Spain.
authors.forename: Gerard
authors.initials: G
authors.lastname: Espinosa
authors.affiliation: Department of Internal Medicine, Bellvitge University Hospital-IDIBELL, L'Hospitalet de Llobregat, Barcelona, and Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, Barcelona, Spain.
authors.forename: Xavier
authors.initials: X
authors.lastname: Corbella
authors.affiliation: Department of Internal Medicine, Hospital Universitario Central de Asturias, Oviedo, Spain.
authors.forename: Dolores
authors.initials: D
authors.lastname: Colunga-Argüelles
authors.affiliation: Department of Internal Medicine, Hospital Universitario Cruces, Barakaldo, Spain.
authors.forename: Maria Victoria
authors.initials: MV
authors.lastname: Egurbide-Arberas
authors.affiliation: Department of Internal Medicine, Hospital Universitario San Cecilio, Granada, Spain.
authors.forename: Norberto
authors.initials: N
authors.lastname: Ortego-Centeno
authors.affiliation: Department of Internal Medicine, Hospital Universitario Virgen de las Nieves, Granada, Spain.
authors.forename: José Antonio
authors.initials: JA
authors.lastname: Vargas-Hitos
authors.affiliation: Department of Internal Medicine, Complejo Hospitalario Universitario de Vigo, Spain.
authors.forename: Mayka
authors.initials: M
authors.lastname: Freire
authors.affiliation: Department of Internal Medicine, Hospital La Paz, Madrid, Spain.
authors.forename: Juan José
authors.initials: JJ
authors.lastname: Ríos-Blanco
authors.affiliation: Department of Internal Medicine, Hospital de Cabueñes, Gijón, Spain.
authors.forename: Luis
authors.initials: L
authors.lastname: Trapiella-Martínez
authors.affiliation: Department of Internal Medicine, Hospital Universitari Mutua de Terrassa, Barcelona, Spain.
authors.forename: Mónica
authors.initials: M
authors.lastname: Rodríguez-Carballeira
authors.affiliation: Vall d'Hebron University Hospital, Department of Internal Medicine, Barcelona, Spain.
authors.forename: Vicent
authors.initials: V
authors.lastname: Fonollosa-Pla
mesh_terms: D000328:Adult; D000368:Aged; D002423:Cause of Death; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012042:Registries; D012595:Scleroderma, Systemic / Q000401:mortality*; D013030:Spain / Q000453:epidemiology; D013997:Time Factors