SLESIS-R: an improved score for prediction of serious infection in patients with systemic lupus erythematosus based on the RELESSER prospective cohort

Objective: To develop an improved score for prediction of severe infection in patients with systemic lupus erythematosus (SLE), namely, the SLE Severe Infection Score-Revised (SLESIS-R) and to validate it in a large multicentre lupus cohort. Methods: We used data from the prospective phase of RELESS...

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Autores: Rua-Figueroa, Íñigo, García de Yébenes, M. Jesús, Martínez-Barrio, Julia, Galindo Izquierdo, María, Calvo Alén, Jaime, Fernández-Nebro, Antonio, Menor-Almagro, Raúl, Carmona, Loreto, Tejera Segura, Beagtriz, Tomero, Eva, Freire-González, Mercedes, Sangüesa, Clara, Horcada-Loreto, Blanco Alonso, Ricardo|||0000-0003-2344-2285, Uriarte-Itzazelaia, Esther, Narváez, Javier, Rosas Gómez de Salazar, José Carlos, Gómez-Sabater, Silvia, Moriano Moralex, Claudia, Andreu, José L.
Tipo de documento: artigo
Data de publicação:2024
País:España
Recursos:Universidad de Cantabria (UC)
Repositório:UCrea Repositorio Abierto de la Universidad de Cantabria
Idioma:inglês
OAI Identifier:oai:repositorio.unican.es:10902/33029
Acesso em linha:https://hdl.handle.net/10902/33029
Access Level:Acceso aberto
Palavra-chave:Epidemiology
Lupus erythematosus, systemic
Risk factors
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spelling SLESIS-R: an improved score for prediction of serious infection in patients with systemic lupus erythematosus based on the RELESSER prospective cohortRua-Figueroa, ÍñigoGarcía de Yébenes, M. JesúsMartínez-Barrio, JuliaGalindo Izquierdo, MaríaCalvo Alén, JaimeFernández-Nebro, AntonioMenor-Almagro, RaúlCarmona, LoretoTejera Segura, BeagtrizTomero, EvaFreire-González, MercedesSangüesa, ClaraHorcada-LoretoBlanco Alonso, Ricardo|||0000-0003-2344-2285Uriarte-Itzazelaia, EstherNarváez, JavierRosas Gómez de Salazar, José CarlosGómez-Sabater, SilviaMoriano Moralex, ClaudiaAndreu, José L.EpidemiologyLupus erythematosus, systemicRisk factorsObjective: To develop an improved score for prediction of severe infection in patients with systemic lupus erythematosus (SLE), namely, the SLE Severe Infection Score-Revised (SLESIS-R) and to validate it in a large multicentre lupus cohort. Methods: We used data from the prospective phase of RELESSER (RELESSER-PROS), the SLE register of the Spanish Society of Rheumatology. A multivariable logistic model was constructed taking into account the variables already forming the SLESIS score, plus all other potential predictors identified in a literature review. Performance was analysed using the C-statistic and the area under the receiver operating characteristic curve (AUROC). Internal validation was carried out using a 100-sample bootstrapping procedure. ORs were transformed into score items, and the AUROC was used to determine performance. Results: A total of 1459 patients who had completed 1 year of follow-up were included in the development cohort (mean age, 49±13 years; 90% women). Twenty-five (1.7%) had experienced ≥1 severe infection. According to the adjusted multivariate model, severe infection could be predicted from four variables: age (years) ≥60, previous SLE-related hospitalisation, previous serious infection and glucocorticoid dose. A score was built from the best model, taking values from 0 to 17. The AUROC was 0.861 (0.777-0.946). The cut-off chosen was ≥6, which exhibited an accuracy of 85.9% and a positive likelihood ratio of 5.48. Conclusions: SLESIS-R is an accurate and feasible instrument for predicting infections in patients with SLE. SLESIS-R could help to make informed decisions on the use of immunosuppressants and the implementation of preventive measures.Funding: The authors declare that financial support for this study was received from the Spanish Foundation of Rheumatology (2021 research grant to the main author). The RELESSER-PROS register received financial support from GSK. Acknowledgements: We are grateful to the RELESSER group collaborators for their invaluable contributions to register data collection. We also are grateful to the employees of the Spanish Rheumatology Society Research Unit for their commitment and professionalism. Finally, we are also grateful to SER for their review of the English translation of the manuscript.BMJ Publishing GroupUniversidad de Cantabria20242024-01-01journal articlehttp://purl.org/coar/resource_type/c_6501NAhttp://purl.org/coar/version/c_be7fb7dd8ff6fe43info:eu-repo/semantics/articlehttps://hdl.handle.net/10902/33029Lupus Science and Medicine, 2024, 11, e001096reponame:UCrea Repositorio Abierto de la Universidad de Cantabriainstname:Universidad de Cantabria (UC)Inglésengopen accesshttp://purl.org/coar/access_right/c_abf2Attribution-NonCommercial 4.0 Internationalhttp://creativecommons.org/licenses/by-nc/4.0/info:eu-repo/semantics/openAccessoai:repositorio.unican.es:10902/330292026-06-02T12:39:31Z
dc.title.none.fl_str_mv SLESIS-R: an improved score for prediction of serious infection in patients with systemic lupus erythematosus based on the RELESSER prospective cohort
title SLESIS-R: an improved score for prediction of serious infection in patients with systemic lupus erythematosus based on the RELESSER prospective cohort
spellingShingle SLESIS-R: an improved score for prediction of serious infection in patients with systemic lupus erythematosus based on the RELESSER prospective cohort
Rua-Figueroa, Íñigo
Epidemiology
Lupus erythematosus, systemic
Risk factors
title_short SLESIS-R: an improved score for prediction of serious infection in patients with systemic lupus erythematosus based on the RELESSER prospective cohort
title_full SLESIS-R: an improved score for prediction of serious infection in patients with systemic lupus erythematosus based on the RELESSER prospective cohort
title_fullStr SLESIS-R: an improved score for prediction of serious infection in patients with systemic lupus erythematosus based on the RELESSER prospective cohort
title_full_unstemmed SLESIS-R: an improved score for prediction of serious infection in patients with systemic lupus erythematosus based on the RELESSER prospective cohort
title_sort SLESIS-R: an improved score for prediction of serious infection in patients with systemic lupus erythematosus based on the RELESSER prospective cohort
dc.creator.none.fl_str_mv Rua-Figueroa, Íñigo
García de Yébenes, M. Jesús
Martínez-Barrio, Julia
Galindo Izquierdo, María
Calvo Alén, Jaime
Fernández-Nebro, Antonio
Menor-Almagro, Raúl
Carmona, Loreto
Tejera Segura, Beagtriz
Tomero, Eva
Freire-González, Mercedes
Sangüesa, Clara
Horcada-Loreto
Blanco Alonso, Ricardo|||0000-0003-2344-2285
Uriarte-Itzazelaia, Esther
Narváez, Javier
Rosas Gómez de Salazar, José Carlos
Gómez-Sabater, Silvia
Moriano Moralex, Claudia
Andreu, José L.
author Rua-Figueroa, Íñigo
author_facet Rua-Figueroa, Íñigo
García de Yébenes, M. Jesús
Martínez-Barrio, Julia
Galindo Izquierdo, María
Calvo Alén, Jaime
Fernández-Nebro, Antonio
Menor-Almagro, Raúl
Carmona, Loreto
Tejera Segura, Beagtriz
Tomero, Eva
Freire-González, Mercedes
Sangüesa, Clara
Horcada-Loreto
Blanco Alonso, Ricardo|||0000-0003-2344-2285
Uriarte-Itzazelaia, Esther
Narváez, Javier
Rosas Gómez de Salazar, José Carlos
Gómez-Sabater, Silvia
Moriano Moralex, Claudia
Andreu, José L.
author_role author
author2 García de Yébenes, M. Jesús
Martínez-Barrio, Julia
Galindo Izquierdo, María
Calvo Alén, Jaime
Fernández-Nebro, Antonio
Menor-Almagro, Raúl
Carmona, Loreto
Tejera Segura, Beagtriz
Tomero, Eva
Freire-González, Mercedes
Sangüesa, Clara
Horcada-Loreto
Blanco Alonso, Ricardo|||0000-0003-2344-2285
Uriarte-Itzazelaia, Esther
Narváez, Javier
Rosas Gómez de Salazar, José Carlos
Gómez-Sabater, Silvia
Moriano Moralex, Claudia
Andreu, José L.
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv Universidad de Cantabria
dc.subject.none.fl_str_mv Epidemiology
Lupus erythematosus, systemic
Risk factors
topic Epidemiology
Lupus erythematosus, systemic
Risk factors
description Objective: To develop an improved score for prediction of severe infection in patients with systemic lupus erythematosus (SLE), namely, the SLE Severe Infection Score-Revised (SLESIS-R) and to validate it in a large multicentre lupus cohort. Methods: We used data from the prospective phase of RELESSER (RELESSER-PROS), the SLE register of the Spanish Society of Rheumatology. A multivariable logistic model was constructed taking into account the variables already forming the SLESIS score, plus all other potential predictors identified in a literature review. Performance was analysed using the C-statistic and the area under the receiver operating characteristic curve (AUROC). Internal validation was carried out using a 100-sample bootstrapping procedure. ORs were transformed into score items, and the AUROC was used to determine performance. Results: A total of 1459 patients who had completed 1 year of follow-up were included in the development cohort (mean age, 49±13 years; 90% women). Twenty-five (1.7%) had experienced ≥1 severe infection. According to the adjusted multivariate model, severe infection could be predicted from four variables: age (years) ≥60, previous SLE-related hospitalisation, previous serious infection and glucocorticoid dose. A score was built from the best model, taking values from 0 to 17. The AUROC was 0.861 (0.777-0.946). The cut-off chosen was ≥6, which exhibited an accuracy of 85.9% and a positive likelihood ratio of 5.48. Conclusions: SLESIS-R is an accurate and feasible instrument for predicting infections in patients with SLE. SLESIS-R could help to make informed decisions on the use of immunosuppressants and the implementation of preventive measures.
publishDate 2024
dc.date.none.fl_str_mv 2024
2024-01-01
dc.type.none.fl_str_mv journal article
http://purl.org/coar/resource_type/c_6501
NA
http://purl.org/coar/version/c_be7fb7dd8ff6fe43
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv https://hdl.handle.net/10902/33029
url https://hdl.handle.net/10902/33029
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
Attribution-NonCommercial 4.0 International
http://creativecommons.org/licenses/by-nc/4.0/
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
http://purl.org/coar/access_right/c_abf2
Attribution-NonCommercial 4.0 International
http://creativecommons.org/licenses/by-nc/4.0/
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv BMJ Publishing Group
publisher.none.fl_str_mv BMJ Publishing Group
dc.source.none.fl_str_mv Lupus Science and Medicine, 2024, 11, e001096
reponame:UCrea Repositorio Abierto de la Universidad de Cantabria
instname:Universidad de Cantabria (UC)
instname_str Universidad de Cantabria (UC)
reponame_str UCrea Repositorio Abierto de la Universidad de Cantabria
collection UCrea Repositorio Abierto de la Universidad de Cantabria
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,812429

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