Background/Purpose: The DANGER score can predict mortality in patients with ANCA-associated vasculitis (AAV) with glomerulonephritis (GN). However, this score has not been widely validated and, moreover, there is no evidence of its use in AAV patients without GN. The aim of this study was to evaluate the performance of this score in AAV patients with or without GN from a Latin American cohort.

Methods: This was a medical records review study which included patients from the Almenara Vasculitis Cohort who had at least one visit between January 1990 and December 2024. Diagnosis of either microscopic polyangiitis (MPA) or granulomatosis with polyangiitis were included. Mortality was determined as the vital status according to the official information from the Peruvian Department of Health. Sociodemographic and clinical features were obtained. The DANGER score includes four variables: age at diagnosis, history of hypertension or cardiac disease, and creatinine and hemoglobin levels at diagnosis. This score stratifies the risk of mortality in low, intermediate and high. Unadjusted and adjusted Cox regression models were done to assess the impact of the DANGER score. The model was adjusted for age at diagnosis, gender and type of diagnosis.

Results: Two hundred twenty-five patients were enrolled; most of them were female [154 (68.4%)]. Mean of age and time of follow-up were 59.4 (12.6) and 7.7 (7.1) years, respectively. MPA was the most frequent diagnosis [177 (78.7%)]. During the follow-up, 110 (48.9%) patients died. As to the DANGER score, 105 (46.7%), 113 (50.2%) and 7 (3.1%) patients had low, intermediate and high risk of mortality, respectively. Furthermore, each risk category was predictive of mortality in the unadjusted and adjusted analyses (Table 1). Overall survival according to the stratification is depicted in Figure 1.

Conclusion: The DANGER score had good performance in AAV patients with or without GN in a Latin American cohort. More studies in other populations are necessary to validate these findings.

Table 1. Unadjusted and adjusted analyses.

Figure 1. Kaplan-Meier plot of survival according to categories by the DANGER score.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/danger-score-as-predictor-of-mortality-in-anca-associated-vasculitis-with-or-without-glomerulonephritis-data-from-the-almenara-vasculitis-cohort/