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Functional disability and its predictors in systemic sclerosis : a study from the DeSScipher project within the EUSTAR group

(2018) RHEUMATOLOGY. 57(3). p.441-450
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Abstract
The multisystem manifestations of SSc can greatly impact patients' quality of life. The aim of this study was to identify factors associated with disability in SSc. SSc patients from the prospective DeSScipher cohort who had completed the scleroderma health assessment questionnaire (SHAQ), a disability score that combines the health assessment questionnaire and five visual analogue scales, were included in this analysis. The effect of factors possibly associated with disability was analysed with multiple linear regressions. The mean SHAQ and HAQ scores of the 944 patients included were 0.87 (s.d. = 0.66) and 0.92 (s.d. = 0.78); 59% of the patients were in the mild to moderate difficulty SHAQ category (0 a (c) 1/2 SHAQ < 1), 34% in the moderate to severe disability category (1 a (c) 1/2 SHAQ < 2) and 7% in the severe to very severe disability category (2 a (c) 1/2 SHAQ a (c) 1/2 3). The means of the visual analogue scales scores were in order of magnitude: overall disease severity (37 mm), RP (31 mm), pulmonary symptoms (24 mm), gastrointestinal symptoms (20 mm) and digital ulcers (19 mm). In multiple regression, the main factors associated with high SHAQ scores were the presence of dyspnoea [modified New York Heart Association (NYHA) class IV (regression coefficient B = 0.62), modified NYHA class III (B = 0.53) and modified NYHA class II (B = 0.21; all modified NYHA class I)], FM (B = 0.37), muscle weakness (B = 0.27), digital ulcers (B = 0.20) and gastrointestinal symptoms (oesophageal symptoms, B = 0.16; stomach symptoms, B = 0.15; intestinal symptoms, B = 0.15). SSc patients perceive dyspnoea, pain, digital ulcers, muscle weakness and gastrointestinal symptoms as the main factors driving their level of disability, unlike physicians who emphasize objective measures of disability.
Keywords
systemic sclerosis, functional disability, scleroderma health assessment questionnaire, predictors of disability, HEALTH-ASSESSMENT QUESTIONNAIRE, QUALITY-OF-LIFE, EULAR SCLERODERMA TRIALS, RESEARCH GROUP DATABASE, RHEUMATOID-ARTHRITIS, RAYNAUDS-PHENOMENON, PATIENT PERCEPTION, CLINICAL-TRIALS, SYMPTOM BURDEN, DISEASE

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Chicago
Jaeger, Veronika K, Oliver Distler, Britta Maurer, Laszlo Czirják, Veronika Lóránd, Gabriele Valentini, Serena Vettori, et al. 2018. “Functional Disability and Its Predictors in Systemic Sclerosis : a Study from the DeSScipher Project Within the EUSTAR Group.” Rheumatology 57 (3): 441–450.
APA
Jaeger, V. K., Distler, O., Maurer, B., Czirják, L., Lóránd, V., Valentini, G., Vettori, S., et al. (2018). Functional disability and its predictors in systemic sclerosis : a study from the DeSScipher project within the EUSTAR group. RHEUMATOLOGY, 57(3), 441–450.
Vancouver
1.
Jaeger VK, Distler O, Maurer B, Czirják L, Lóránd V, Valentini G, et al. Functional disability and its predictors in systemic sclerosis : a study from the DeSScipher project within the EUSTAR group. RHEUMATOLOGY. 2018;57(3):441–50.
MLA
Jaeger, Veronika K, Oliver Distler, Britta Maurer, et al. “Functional Disability and Its Predictors in Systemic Sclerosis : a Study from the DeSScipher Project Within the EUSTAR Group.” RHEUMATOLOGY 57.3 (2018): 441–450. Print.
@article{8545908,
  abstract     = {The multisystem manifestations of SSc can greatly impact patients' quality of life. The aim of this study was to identify factors associated with disability in SSc. 
SSc patients from the prospective DeSScipher cohort who had completed the scleroderma health assessment questionnaire (SHAQ), a disability score that combines the health assessment questionnaire and five visual analogue scales, were included in this analysis. The effect of factors possibly associated with disability was analysed with multiple linear regressions. 
The mean SHAQ and HAQ scores of the 944 patients included were 0.87 (s.d. = 0.66) and 0.92 (s.d. = 0.78); 59% of the patients were in the mild to moderate difficulty SHAQ category (0 a (c) 1/2 SHAQ < 1), 34% in the moderate to severe disability category (1 a (c) 1/2 SHAQ < 2) and 7% in the severe to very severe disability category (2 a (c) 1/2 SHAQ a (c) 1/2 3). The means of the visual analogue scales scores were in order of magnitude: overall disease severity (37 mm), RP (31 mm), pulmonary symptoms (24 mm), gastrointestinal symptoms (20 mm) and digital ulcers (19 mm). In multiple regression, the main factors associated with high SHAQ scores were the presence of dyspnoea [modified New York Heart Association (NYHA) class IV (regression coefficient B = 0.62), modified NYHA class III (B = 0.53) and modified NYHA class II (B = 0.21; all modified NYHA class I)], FM (B = 0.37), muscle weakness (B = 0.27), digital ulcers (B = 0.20) and gastrointestinal symptoms (oesophageal symptoms, B = 0.16; stomach symptoms, B = 0.15; intestinal symptoms, B = 0.15). 
SSc patients perceive dyspnoea, pain, digital ulcers, muscle weakness and gastrointestinal symptoms as the main factors driving their level of disability, unlike physicians who emphasize objective measures of disability.},
  author       = {Jaeger, Veronika K and Distler, Oliver and Maurer, Britta and Czirják, Laszlo and Lóránd, Veronika and Valentini, Gabriele and Vettori, Serena and Del Galdo, Francesco and Abignano, Giuseppina and Denton, Christopher and Nihtyanova, Svetlana and Allanore, Yannick and Avouac, Jerome and Riemekasten, Gabriele and Siegert, Elise and Huscher, Dörte and Matucci-Cerinic, Marco and Guiducci, Serena and Frerix, Marc and Tarner, Ingo H and Garay Toth, Beata and Fankhauser, Beat and Umbricht, Jörg and Zakharova, Anastasia and Mihai, Carina and Cozzi, Franco and Yavuz, Sule and Hunzelmann, Nicolas and Rednic, Simona and Vacca, Alessandra and Schmeiser, Tim and Riccieri, Valeria and García de la Peña Lefebvre, Paloma and Gabrielli, Armando and Krummel-Lorenz, Brigitte and Martinovic, Duska and Ancuta, Codrina and Smith, Vanessa and Müller-Ladner, Ulf and Walker, Ulrich A},
  issn         = {1462-0324},
  journal      = {RHEUMATOLOGY},
  keywords     = {systemic sclerosis,functional disability,scleroderma health assessment questionnaire,predictors of disability,HEALTH-ASSESSMENT QUESTIONNAIRE,QUALITY-OF-LIFE,EULAR SCLERODERMA TRIALS,RESEARCH GROUP DATABASE,RHEUMATOID-ARTHRITIS,RAYNAUDS-PHENOMENON,PATIENT PERCEPTION,CLINICAL-TRIALS,SYMPTOM BURDEN,DISEASE},
  language     = {eng},
  number       = {3},
  pages        = {441--450},
  title        = {Functional disability and its predictors in systemic sclerosis : a study from the DeSScipher project within the EUSTAR group},
  url          = {http://dx.doi.org/10.1093/rheumatology/kex182},
  volume       = {57},
  year         = {2018},
}

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