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

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

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

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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 cohort.Rua-Figueroa IGarcía de Yébenes MJMartinez-Barrio JGalindo Izquierdo MCalvo Alén JFernandez-Nebro AMenor-Almagro RCarmona LTejera Segura BTomero EFreire-González MSangüesa CHorcada LBlanco RUriarte Itzazelaia ENarváez JRosas Gómez de Salazar JCGómez-Sabater SMorales CMAndreu JLSegarra VTAurrecoechea EPerez ANóvoa Medina JSalgado ELozano-Rivas NMontilla CRuiz-Lucea EArevalo MIñiguez CGarcía-Villanueva MJExposito LIbáñez-Barceló MBonilla GCarrión-Barberà IErausquin CFragio Gil JJPecondón AToyos FJCobo TMuñoz-Jiménez AOller JNolla JMPego-Reigosa JMepidemiologylupus 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.BMJ PUBLISHING GROUP2024info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://isabial.portalinvestigacion.com/publicaciones10399https://lupus.bmj.com/content/11/1/e001096Lupus Science & MedicineISSN: 20538790reponame:r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicanteinstname:Instituto de Investigación Biomédica y Sanitaria de Alicante (ISABIAL)Inglésinfo:eu-repo/semantics/openAccessoai:isabial.fundanetsuite.com:p103992026-06-12T10:20:37Z
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 I 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 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
author	Rua-Figueroa I
author_facet	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
author_role	author
author2	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
author2_role	author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author
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
dc.type.none.fl_str_mv	info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion
format	article
status_str	publishedVersion
dc.identifier.none.fl_str_mv	https://isabial.portalinvestigacion.com/publicaciones10399 https://lupus.bmj.com/content/11/1/e001096
url	https://isabial.portalinvestigacion.com/publicaciones10399 https://lupus.bmj.com/content/11/1/e001096
dc.language.none.fl_str_mv	Inglés
language_invalid_str_mv	Inglés
dc.rights.none.fl_str_mv	info:eu-repo/semantics/openAccess
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 & Medicine ISSN: 20538790 reponame:r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicante instname:Instituto de Investigación Biomédica y Sanitaria de Alicante (ISABIAL)
instname_str	Instituto de Investigación Biomédica y Sanitaria de Alicante (ISABIAL)
reponame_str	r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicante
collection	r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicante
repository.name.fl_str_mv
repository.mail.fl_str_mv
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SLESIS-R: an improved score for prediction of serious infection in patients with systemic lupus erythematosus based on the RELESSER prospective cohort.

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