Crowson et al developed a score for predicting the risk of a serious infection in a patient with rheumatoid arthritis (RA). This can help to identify a patient who may benefit from closer monitoring or more aggressive management. The authors are from the Mayo Clinic.
Patient selection: rheumatoid arthritis
NOTE: The study period appears to have preceded widespread use of targeted therapies.
Parameters:
(1) age in years
(2) history of a previous serious infection
(3) extra-articular manifestations of rheumatoid arthritis
(4) ESR in mm per hour
(5) corticosteroid dosage
(6) number of comorbid conditions
|
Parameter |
Findings |
Points |
|
age |
< 60 years of age |
0 |
|
|
60 to 79.9 years |
0.404 |
|
|
>= 80 years |
0.857 |
|
history |
never |
0 |
|
|
> 3 years ago |
0 |
|
|
1 to 3 years ago |
1.670 |
|
|
in the past year |
2.138 |
|
extra-articular |
no |
0 |
|
|
yes |
0.620 |
|
ESR |
< 30 mm per hour |
0 |
|
|
30 to 50 mm per hour |
0.180 |
|
|
> 50 mm per hour |
0.611 |
|
corticosteroid dosing |
none |
0 |
|
|
<= 10 mg per day |
0.553 |
|
|
> 10 mg per day |
1.281 |
|
number of comorbidities |
0 |
0 |
|
|
1 |
0.675 |
|
|
2 or more |
1.024 |
X
= SUM(points for all 6 parameters)
risk of serious infection in the next year =
= 1 – (0.989^(EXP(X)))
Purpose: To identify the risk for serious infection within the next year for a patient with rheumatoid arthritis (RA) using the score of Crowson et al.
Specialty: Immunology/Rheumatology
Objective: risk factors, complications, disease progression
ICD-10: M05.3, M06, M13,
