A Review of the Causes of Death Among Patients in the Southern Alberta Vasculitis Registry
Bibliographic record
Abstract
Objectives To evaluate patient causes of death from the Southern Alberta Vasculitis Registry (SAVR). Methods Patient cases were reviewed from the SAVR up to the cutoff of July 2024. Descriptive statistics were used to describe the findings. Results There were 54 deceased patients in the SAVR. 25 patients were male (46%) and 29 were female (54%). The average age of death was 76.4 years. The average years between vasculitis diagnosis and death was 5.7 years (range: 0-21 years). A full summary of represented vasculitides is seen in Figure 1 but the top 3 vasculitis types were giant cell arteritis (26%), granulomatosis with polyangiitis (20%), and microscopic polyangiitis (11%). Infection was the most common cause of death at 27.8% (15/54) with pneumonia being the most common form of infection (13%, 7/54). Reviewing the charts for these cases, 53% (8/15) of patients who died of an infection were on a corticosteroid (all prednisone). The average prednisone dose at time of death was 17.75mg (range 2-60mg). 75% (6/8) of these patients had active vasculitis at the time of death. Cancer and cardiovascular disease were tied for the second leading cause of death (20%,11/54 for each). Vasculitis preceded cancer in 10/11 cases. In the exception case, the patient had vasculitis secondary to endometrial cancer. Lung cancer was the most common type of cancer leading to death (36% of cancer cases, 4/11). The smoking data available was incomplete, limiting further analysis. There was 1 case of bladder cancer (occurred in patient with cumulative cyclophosphamide exposure >100g), but the cause of death in this patient was pancreatic cancer. Aside from being a leading cause of death, 41% (22/54) patients had some form of cancer at time of death. Heart failure and stroke were the most common cardiovascular causes of death. Conclusion Infection, cancer, and cardiovascular disease as leading causes death in the SAVR registry are in keeping with findings in the literature. [1,2] Patients in this cohort were older at diagnosis (70.7 years) than the wider SAVR (58.1). The high rate of death from cancer and high prevalence of cancer in this cohort represent noteworthy findings. The impact of long-term immunosuppression (length time and higher doses), use of agents associated with cancer (ex. cyclophosphamide, azathioprine), and older patient age may all be contributing factors. Future studies will look at a rate matching by vasculitis type against the local general population and other vasculitis studies. [1.] Flossmann O. Annals of the Rheumatic Diseases 2010:24;70(3):488-94. [2.] Antonini L. Rheumatology 2021;60(11):5080-8.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.006 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.010 | 0.014 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".