Legge et al identified factors associated with organ damage progression in a patient with systemic lupus erythematosus (SLE). These can help to identify a patient who may benefit from more aggressive management. The authors are from Dalhousie University and the Nova Scotia Health Authority.
Patient selection: SLE
Outcome: increase in SLICC/ACR damage index
Risk factors for progression of organ damage:
(1) age of the patient (mean age was 44 years of age with standard deviation 14.6)
(2) SLICC/ACR damage index at baseline (indicates pre-existing damage)
(3) number of ACR classificaton criteria
(4) therapy with immunosuppressive drugs
(5) cigarette smoking
(6) high mean C-reactive protein
Parameter |
Finding |
Points |
age of the patient |
younger |
0 |
|
older |
1 |
SLICC/ACR damage index at baseline |
0 |
0 |
|
>= 1 |
1 |
ACR classification criteria |
< 8 |
0 |
|
>= 8 |
1 |
immunosuppressive drugs |
no |
0 |
|
yes |
1 |
cigarette smoking |
no |
0 |
|
yes (current or past) |
1 |
C-reactive protein |
low |
0 |
|
high |
1 |
total number of predictors =
= SUM(points for all 6 risk factors)
Interpretation:
• minimum score: 0
• maximum score: 6
• The higher the score the greater the risk for progression in organ damage.
Specialty: Immunology/Rheumatology