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 I, García de Yébenes MJ, Martinez-Barrio J, Galindo Izquierdo M, Calvo Alén J, Fernandez-Nebro A, Menor-Almagro R, Carmona L, Tejera Segura B, Tomero E, Freire-González M, Sangüesa C, Horcada L, Blanco R, Uriarte Itzazelaia E, Narváez J, Rosas Gómez de Salazar JC, Gómez-Sabater S, Morales CM, Andreu JL, Segarra VT, Aurrecoechea E, Perez A, Nóvoa Medina J, Salgado E, Lozano-Rivas N, Montilla C, Ruiz-Lucea E, Arevalo M, Iñiguez C, García-Villanueva MJ, Exposito L, Ibáñez-Barceló M, Bonilla G, Carrión-Barberà I, Erausquin C, Fragio Gil JJ, Pecondón A, Toyos FJ, Cobo T, Muñoz-Jiménez A, Oller J, Nolla JM, Pego-Reigosa JM
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2024
País:España
Institución:Instituto de Investigación Biomédica y Sanitaria de Alicante (ISABIAL)
Repositorio:r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicante
OAI Identifier:oai:isabial.fundanetsuite.com:p10399
Acceso en línea:https://isabial.portalinvestigacion.com/publicaciones10399
https://lupus.bmj.com/content/11/1/e001096
Access Level:acceso abierto
Palabra clave:epidemiology
lupus erythematosus, systemic
risk factors
Descripción
Sumario: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.

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