Use this URL to cite or link to this record in EThOS: https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.774025
Title: A study of comorbidities in ANCA-associated vasculitis
Author: Sarica, Shifa
ISNI:       0000 0004 7961 256X
Awarding Body: University of Aberdeen
Current Institution: University of Aberdeen
Date of Award: 2019
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Abstract:
Background: As patient longevity increases in ANCA-associated vasculitis (AAV), a complex multisystem autoimmune disease which is almost always fatal when untreated, comorbidities rather than active AAV itself drive adverse patient outcomes. However, the comorbidity burden in AAV remains unclear. Aims This study aimed to increase the understanding of the comorbidity burden in AAV using routinely-collected healthcare data. Objectives were to (i)assess the comorbidity burden in AAV by quantifying and comparing it to that in the general population, (ii)identify putative risk factors for comorbidity, and (iii)validate comorbidity recording in routinely-collected databases. Methods: Two longitudinal matched-cohort studies comprising AAV patients and age-, sex- and geography-matched general population patients were formed. Data sources included primary care interactions in the first cohort study, while the second study retrieved records of hospitalisation, cancer, infections, and deaths via data linkage with national healthcare databases in Scotland. Validation methodology was used to assess the quality of comorbidity recording in these databases. Results: Compared with the general population, AAV patients were substantially more likely to develop comorbidities during follow-up. In both cohorts, approximately half of the AAV patients developed at least one comorbidity by five years of follow-up. The risk for most comorbidities was the highest during the first two years of follow-up. Several AAV-related and traditional risk factors were identified for the most common comorbidities. The validity of comorbidity recording in routinely-collected healthcare databases was found to be high. Conclusions: AAV patients are at a high risk of comorbidities, especially during the early years of diagnosis. Findings reinforce the need for adopting a 'holistic' approach rather 2 than a single-disease perspective when managing AAV. Future research could explore trajectories of comorbidity in AAV which may inform stratification of patient groups to develop effective management strategies to improve both the care and quality of life in AAV patients.
Supervisor: Black, Corrinda ; Basu, Neil ; Marks, Angharad Sponsor: NHS Grampian Endowment Fund
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID: uk.bl.ethos.774025  DOI: Not available
Keywords: Wegener's granulomatosis ; Churg-Strauss syndrome ; Vasculitis ; Comorbidity ; Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis
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