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Authors
Gabel, Colleen KNguyen, Emily D
Chakrala, Teja
Blum, Amy E
François, Josie
Chand, Sidharth
Rrapi, Renajd
Baker, Olesya
Dobry, Allison S
Garza-Mayers, Anna Cristina
Ko, Lauren N
Shah, Radhika
St John, Jessica
Nigwekar, Sagar U
Kroshinsky, Daniela
Faculty Advisor
Daniela KroshinskyDocument Type
Journal ArticlePublication Date
2020-10-29
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Background: Calciphylaxis is a rare thrombotic vasculopathy characterized by high morbidity and mortality. There is a paucity of studies examining longitudinal outcomes. Objective: To assess mortality, days spent in the hospital, and amputations in patients with calciphylaxis. Methods: A retrospective medical record review was conducted in 145 patients diagnosed with calciphylaxis at an urban tertiary care hospital from January 2006 to December 2018. Results: Six-month mortality was 37.2%, and 1-year mortality was 44.1%. Patients with nephrogenic calciphylaxis had worse survival than those with nonnephrogenic calciphylaxis (P = .007). This difference in survival disappeared when limiting mortality to deaths due to calciphylaxis. Age (P = .003) and end-stage renal disease (P = .01) were risk factors associated with 1-year mortality. Diabetes mellitus was associated with greater total hospitalization days (coefficient, 1.1; 95% confidence interval, 1.01-1.4); bedside debridement was associated with fewer hospitalization days (coefficient, 0.8; 95% confidence interval, 0.7-0.9). Amputations were not associated with any of the examined risk factors. The use of warfarin followed by a transition to nonwarfarin anticoagulation was associated with decreased hazard of death (P = .01). Limitations: Retrospective nature. Conclusions: Calciphylaxis remains a complex, heterogeneous disease. Mortality is lower in patients with nonnephrogenic disease. These findings may be incorporated during discussions regarding the goals of care to facilitate informed shared decision making.Source
Gabel CK, Nguyen ED, Chakrala T, Blum AE, François J, Chand S, Rrapi R, Baker O, Dobry AS, Garza-Mayers AC, Ko LN, Shah R, St John J, Nigwekar SU, Kroshinsky D. Assessment of outcomes of calciphylaxis. J Am Acad Dermatol. 2021 Oct;85(4):1057-1064. doi: 10.1016/j.jaad.2020.10.067. Epub 2020 Oct 29. PMID: 33130181.DOI
10.1016/j.jaad.2020.10.067Permanent Link to this Item
http://hdl.handle.net/20.500.14038/51233PubMed ID
33130181Notes
Colleen Gabel participated in this study as a medical student in the Senior Scholars research program at the University of Massachusetts Medical School.Rights
Copyright © 2020 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.ae974a485f413a2113503eed53cd6c53
10.1016/j.jaad.2020.10.067