Association between Functional Independence Measure and mortality in patients with anti-neutrophil cytoplasmic antibody-associated vasculitis: A single-center observational study

Mod Rheumatol. 2021 Mar;31(2):399-407. doi: 10.1080/14397595.2020.1740393. Epub 2020 Mar 24.

Abstract

Objectives: Previous studies have identified several predictors of mortality in patients with anti-neutrophil cytoplasmic antibody-associated vasculitis (AAV). However, functional dependence as a predictor of mortality has never been reported. In this study, we investigated whether Functional Independence Measure (FIM) was associated with mortality in AAV patients.

Methods: We analyzed 52 adults with biopsy-proven AAV in Teine Keijinkai Medical Center between January 2000 and March 2019. Adjusted Cox regression analyses were conducted to evaluate the association between three FIM-based groups and all-cause mortality. Estimates were calculated as hazard ratios with 95% confidence intervals (95% CIs).

Results: During a median follow-up of 2.3 years (interquartile range, 0.7-4.6 years), death occurred in 15 patients (29%). Compared to the highest-FIM group (91-126 points), the adjusted hazard ratios for the intermediate- (55-90 points) and lowest-FIM (18-54 points) groups were 3.59 (95% CIs, 0.40-32.0) and 15.7 (95% CIs, 2.07-119) for all-cause mortality, respectively. In addition, the lower-FIM groups were associated with higher mortality (p=.0179).

Conclusion: This study suggested that the FIM score is a predictor of all-cause mortality in AAV patients. Future studies will have to investigate whether FIM assessment leads to better outcomes.

Keywords: Anti-neutrophil cytoplasmic antibody-associated vasculitis; Functional Independence Measure; vasculitis mortality.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Aged
  • Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis / mortality*
  • Female
  • Functional Status*
  • Humans
  • Male
  • Middle Aged
  • Proportional Hazards Models